Pretreatment prognostic factors and treatment outcome in elderly patients with de novo acute myeloid leukemia
| Autor: | Chao-Hung Ho, M.-H. Yang, Hui Chi Hsu, Cheng Hwai Tzeng, Y.-B. Yu, Chih-Cheng Chen, Jie Yu You, K.-D. Lee, W.-K. Chau, Jyh Pyng Gau, C.-F. Yang, W.-K. Kwang |
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| Rok vydání: | 2005 |
| Předmět: |
Male
Oncology medicine.medical_specialty Hemoglobins Leukocyte Count Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols Biomarkers Tumor medicine Humans Anthracyclines Leukocytosis Survival rate Aged Neoplasm Staging Aged 80 and over Chromosome Aberrations L-Lactate Dehydrogenase Performance status Platelet Count business.industry Remission Induction Cytarabine Myeloid leukemia Induction chemotherapy Hematology Prognosis medicine.disease Chemotherapy regimen Surgery Survival Rate Leukemia Regimen Treatment Outcome Leukemia Myeloid Karyotyping Acute Disease Female medicine.symptom business |
| Zdroj: | Annals of Oncology. 16:1366-1373 |
| ISSN: | 0923-7534 |
| Popis: | BACKGROUND Elderly patients with acute myeloid leukemia (AML) generally have an unfavorable clinical course and are under-represented in clinical trials. The aim of this study was to analyze the prognosis and treatment outcome of elderly AML patients. PATIENTS AND METHODS We studied 205 AML patients aged 65 years or older at our hospital. Prior to study initiation, we designated 13 variables to be analyzed for their impact on complete remission (CR) rate and overall survival (OS). RESULTS Induction regimen (standard chemotherapy) and good performance status (PS) (Eastern Cooperative Oncology Group PS 0-1) independently influenced the achievement of CR. Multivariate analysis also determined five poor prognostic factors for OS: poor PS (score 2-4), presence of comorbidities, elevated serum lactate dehydrogenase level (> or =2x upper normal limit), extreme leukocytosis (> or =100 x 10(9)/l) and marked thrombocytopenia (< or =20 x 10(9)/l). Age was not an independent contributing factor in terms of either CR attainment or OS duration. Low-risk patients, who possessed one or less non-leukocytosis poor prognostic factor, had significantly longer disease-free survival and OS than their high-risk counterparts. CONCLUSIONS Elderly AML patients should be risk-stratified at diagnosis. Anthracycline-based induction chemotherapy would be the best therapeutic option for such patients. |
| Databáze: | OpenAIRE |
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