NDLI: Intensive chemotherapy does not benefit most older patients (age 70 years or older) with acute myeloid leukemia

Content Provider	PubMed Central
Author	Hagop, Kantarjian Farhad, Ravandi O'brien, Susan Cortes, Jorge Faderl, Stefan Guillermo, Garcia-manero Jabbour, Elias Wierda, William Kadia, Tapan Pierce, Sherry Shan, Jianqin Keating, Michael Freireich, Emil J.
Copyright Year	2010
Abstract	Patients ≥ 70 years of age with acute myeloid leukemia (AML) have a poor prognosis. Recent studies suggested that intensive AML-type therapy is tolerated and may benefit most. We analyzed 446 patients ≥ 70 years of age with AML (≥ 20% blasts) treated with cytarabine-based intensive chemotherapy between 1990 and 2008 to identify risk groups for high induction (8-week) mortality. Excluding patients with favorable karyotypes, the overall complete response rate was 45%, 4-week mortality was 26%, and 8-week mortality was 36%. The median survival was 4.6 months, and the 1-year survival rate was 28%. Survival was similar among patients treated before 2000 and since 2000. A multivariate analysis of prognostic factors for 8-week mortality identified the following to be independently adverse: age ≥ 80 years, complex karyotypes, (≥ 3 abnormalities), poor performance (2-4 Eastern Cooperative Oncology Group), and elevated creatinine > 1.3 mg/dL. Patients with none (28%), 1 (40%), 2 (23%), or ≥ 3 factors (9%) had estimated 8-week mortality rates of 16%, 31%, 55%, and 71% respectively. The 8-week mortality model also predicted for differences in complete response and survival rates. In summary, the prognosis of most patients (72%) ≥ 70 years of age with AML is poor with intensive chemotherapy (8-week mortality ≥ 30%; median survival < 6 months).
Related Links	http://dx.doi.org/10.1182/blood-2010-03-276485
Ending Page	4429
Page Count	8
Starting Page	4422
File Format	PDF
ISSN	00064971
e-ISSN	15280020
Journal	Blood
Issue Number	22
Volume Number	116
Language	English
Publisher	American Society of Hematology
Publisher Date	2010-11-25
Access Restriction	Open
Rights Holder	American Society of Hematology
Subject Keyword	Immunology Cell Biology Biochemistry Hematology Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Cell Biology Hematology Biochemistry Immunology

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