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Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia
Acute myeloid leukemia (AML) represents a major therapeutic challenge in the elderly. Because of the high treatment-related mortality and poor overall outcomes of remission induction therapy, many older patients are not considered candidates for intensive chemotherapy. The current study evaluated pr...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cognizant Communication Corporation
2015
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838424/ https://www.ncbi.nlm.nih.gov/pubmed/25706395 http://dx.doi.org/10.3727/096504014X14146137738547 |
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author | Ross, Kelly Gillespie-Twardy, Amanda L. Agha, Mounzer Raptis, Anastasios Hou, Jing-Zhou Farah, Rafic Redner, Robert L. Im, Annie Duggal, Shrina Ding, Fei Lin, Yan Boyiadzis, Michael |
author_facet | Ross, Kelly Gillespie-Twardy, Amanda L. Agha, Mounzer Raptis, Anastasios Hou, Jing-Zhou Farah, Rafic Redner, Robert L. Im, Annie Duggal, Shrina Ding, Fei Lin, Yan Boyiadzis, Michael |
author_sort | Ross, Kelly |
collection | PubMed |
description | Acute myeloid leukemia (AML) represents a major therapeutic challenge in the elderly. Because of the high treatment-related mortality and poor overall outcomes of remission induction therapy, many older patients are not considered candidates for intensive chemotherapy. The current study evaluated prognostic factors for achievement of complete remission (CR) in newly diagnosed elderly AML patients who were treated with initial intensive chemotherapy. The study included 62 newly diagnosed AML patients ≥70 years who were treated with intensive chemotherapy. The overall response rate (CR and CRp) was 56%. Patients with favorable or intermediate cytogenetics (p = 0.0036) as well as those with primary AML (p = 0.0212) had a higher response rate. The median overall survival for all patients was 6.85 months (95% CI 3.7–13.5 months). The median overall survival for patients achieving remission after intensive induction chemotherapy was significantly higher than those who did not respond to therapy (20.4 months vs. 3.5 months, p < 0.001). The all-cause 4-week mortality rate was 11%, and the all-cause 8-week mortality rate was 17.7%. A subgroup of elderly patients may benefit more from initial intensive induction chemotherapy, specifically those patients with performance status able to tolerate induction chemotherapy and favorable cytogenetic status. However, despite high rates of initial CR, relapse rates are still high, suggesting that alternative strategies of postremission therapy are warranted. |
format | Online Article Text |
id | pubmed-7838424 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Cognizant Communication Corporation |
record_format | MEDLINE/PubMed |
spelling | pubmed-78384242021-02-16 Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia Ross, Kelly Gillespie-Twardy, Amanda L. Agha, Mounzer Raptis, Anastasios Hou, Jing-Zhou Farah, Rafic Redner, Robert L. Im, Annie Duggal, Shrina Ding, Fei Lin, Yan Boyiadzis, Michael Oncol Res Article Acute myeloid leukemia (AML) represents a major therapeutic challenge in the elderly. Because of the high treatment-related mortality and poor overall outcomes of remission induction therapy, many older patients are not considered candidates for intensive chemotherapy. The current study evaluated prognostic factors for achievement of complete remission (CR) in newly diagnosed elderly AML patients who were treated with initial intensive chemotherapy. The study included 62 newly diagnosed AML patients ≥70 years who were treated with intensive chemotherapy. The overall response rate (CR and CRp) was 56%. Patients with favorable or intermediate cytogenetics (p = 0.0036) as well as those with primary AML (p = 0.0212) had a higher response rate. The median overall survival for all patients was 6.85 months (95% CI 3.7–13.5 months). The median overall survival for patients achieving remission after intensive induction chemotherapy was significantly higher than those who did not respond to therapy (20.4 months vs. 3.5 months, p < 0.001). The all-cause 4-week mortality rate was 11%, and the all-cause 8-week mortality rate was 17.7%. A subgroup of elderly patients may benefit more from initial intensive induction chemotherapy, specifically those patients with performance status able to tolerate induction chemotherapy and favorable cytogenetic status. However, despite high rates of initial CR, relapse rates are still high, suggesting that alternative strategies of postremission therapy are warranted. Cognizant Communication Corporation 2015-02-09 /pmc/articles/PMC7838424/ /pubmed/25706395 http://dx.doi.org/10.3727/096504014X14146137738547 Text en Copyright © 2015 Cognizant Comm. Corp. http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is licensed under a Creative Commons Attribution-NonCommercial NoDerivatives 4.0 International License. |
spellingShingle | Article Ross, Kelly Gillespie-Twardy, Amanda L. Agha, Mounzer Raptis, Anastasios Hou, Jing-Zhou Farah, Rafic Redner, Robert L. Im, Annie Duggal, Shrina Ding, Fei Lin, Yan Boyiadzis, Michael Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title | Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title_full | Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title_fullStr | Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title_full_unstemmed | Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title_short | Intensive Chemotherapy in Patients Aged 70 Years or Older Newly Diagnosed With Acute Myeloid Leukemia |
title_sort | intensive chemotherapy in patients aged 70 years or older newly diagnosed with acute myeloid leukemia |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838424/ https://www.ncbi.nlm.nih.gov/pubmed/25706395 http://dx.doi.org/10.3727/096504014X14146137738547 |
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