Acute myeloid leukemia in elderly patients: experience of a single center

Acute myeloid leukemia in elderly patients: experience of a single center

Author Rodrigues, Celso Arrais Autor UNIFESP Google Scholar
Chauffaille, Maria de Lourdes Lopes Ferrari Autor UNIFESP Google Scholar
Pelloso, L.a.f. Autor UNIFESP Google Scholar
Ghaname, F.s. Autor UNIFESP Google Scholar
Kerbauy, Daniela Márcia Bahia Autor UNIFESP Google Scholar
Campos, M.g.v. Autor UNIFESP Google Scholar
Yamamoto, Mihoko Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Acute myeloid leukemia (AML) is a disease predominantly of older adults. Treatment of AML in the elderly is complicated not only by comorbidities but also by the high prevalence of poor prognosis markers. Thirty-one consecutive unselected patients with AML older than 60 years (representing 33% of all AML cases diagnosed at our institution during the same period) were followed over a period of 5 years (1997-2002). A high incidence of AML with multilineage dysplasia (45%) and no favorable cytogenetic abnormalities but 62% intermediate and 38% unfavorable karyotypes were found. Sixteen patients (52%) were selected for induction of intensive cytotoxic treatment and complete remission was achieved only by some of these intensively treated patients (7 of 16). Of these, 3 remained alive without disease (median: 11 months), 1 patient died shortly after complete remission, and 3 patients relapsed and died from refractory disease. Only 1 patient that was refractory to intensive cytotoxic treatment remained alive with disease under supportive care. Fifteen patients (48%) were managed with palliative/supportive care: 7 received palliative treatment and supportive care, 8 received supportive care only, and 4 patients remained alive with disease under supportive care (median: 9 months). Mortality rate was 74% and overall survival at two years was 12%. To the best of our knowledge, there is no previous report regarding elderly patients with AML in Brazilian subsets. The present data are similar to previously reported studies showing that elderly AML patients are not only older but also biologically distinct from younger AML patients, particularly in terms of the high incidence of poor prognostic karyotypes and resistance to therapy.
Keywords Acute myeloid leukemia
Elderly patients
G-banding karyotype
Induction therapy
Overall survival
Language English
Date 2003-06-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 36, n. 6, p. 703-708, 2003.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 703-708
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000183866400004
SciELO ID S0100-879X2003000600004 (statistics in SciELO)

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