Acute myeloid leukemia in the elderly (age 70 yr or older): long‐term survivors

Objective Little data exist regarding long‐term survival in elderly patients with acute myeloid leukemia (AML). Methods In view of the fact that most deaths occurred during the first 3 yr, this study examined long‐term survival in this patient population, defined as overall survival for at least 3 y...

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Bibliographic Details
Published in:European journal of haematology 2017-02, Vol.98 (2), p.134-141
Main Authors: Heiblig, Maël, Elhamri, Mohamed, Le Jeune, Caroline, Laude, Marie‐Charlotte, Deloire, Alexandre, Wattel, Eric, Salles, Gilles, Thomas, Xavier
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Bone Marrow - pathology
Cancer
Chemotherapy
Cytogenetics
elderly
Female
Geriatrics
Humans
Leukemia
Leukemia, Myeloid, Acute - diagnosis
Leukemia, Myeloid, Acute - epidemiology
Leukemia, Myeloid, Acute - mortality
Leukemia, Myeloid, Acute - therapy
Life Sciences
long‐term survivors
Male
Myeloid leukemia
Population Surveillance
prognosis
Remission
Remission Induction
Retreatment
Survival
Survivors
treatment
Treatment Outcome
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Summary:Objective Little data exist regarding long‐term survival in elderly patients with acute myeloid leukemia (AML). Methods In view of the fact that most deaths occurred during the first 3 yr, this study examined long‐term survival in this patient population, defined as overall survival for at least 3 yr with the aim to determine the number of long‐term survivors and to identify factors that might impact on longer survival. Results The criterion for entry into this cohort was fulfilled by 57 patients among 302 seen over a 14‐yr period (19%): 12 patients who never achieved complete remission (CR), 21 patients who relapsed after CR achievement, and 24 patients who achieved CR and did not relapse, including three patients who died while in CR and 21 patients still alive in first CR at the time of analysis. The pretreatment prognostic importance of cytogenetics was still apparent. However, some patients with secondary AML and/or unfavorable‐risk markers belonged to long survivors. The cohort involved mainly patients treated by intensive chemotherapy, but also some patients receiving low‐intensity therapies. Conclusion Improved results should come from a better selection of patients to a more ‘personalized’ therapeutic approach combined with better supportive care assessment.
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.12811