✍ Scribed by Norbert Vey; Diane Coso; Valerie-Jeanne Bardou; Anne-Marie Stoppa; Anne-Chantal Braud; Reda Bouabdallah; Daniele Sainty; Marie-Joelle Mozziconacci; Marina Lafage; Gandhi Damaj; Didier Blaise; Jean-Albert Gastaut; Dominique Maraninchi
No coin nor oath required. For personal study only.
Patients age ≥ 75 years with acute myeloid leukemia (AML) generally are offered palliative treatments instead of induction chemotherapy. The authors conducted a retrospective study comparing the outcomes among these elderly patients with the outcomes among younger patients to assess the impact of intensive treatment approaches in this age group.
One hundred ten consecutive patients age ≥ 75 years with newly diagnosed AML (excluding patients with acute promyelocytic leukemia) were treated in the authors' center over 10 years. Initial treatment was comprised of anthracycline‐based induction chemotherapy (i.e., intravenous idarubicin or daunorubicin for 3 days plus cytarabine [ARAC] for 7 days [3 + 7 regimen] or oral idarubicin) for 62 patients (56%), antimetabolite‐based chemotherapy (including low‐dose ARAC, oral 6‐mercaptopurine plus methotrexate, or hydroxyurea) for 40 patients (36%), and supportive care only for 8 patients (7%). Results were compared with the results from 200 patients ages 65–74 years who were treated during the same period.
A complete response (CR) to anthracycline‐based induction therapy was achieved by 23 of 62 patients (37%), and the 2‐year overall survival rate was 22% (which was not statistically different from the group of patients ages 65–74 years). In a multivariate analysis of the entire study group (310 patients), treatment (anthracycline‐based vs. other) and age as continuous variable were found to affect survival significantly. In a Landmark analysis, the achievement of a CR translated into improved survival in patients age ≥ 75 years.
Patients age ≥ 75 years should not be excluded systematically from intensive chemotherapy regimens. Decisions should be based on stratification systems that include functional status and comorbidity assessments as well as prognostic factors, such as cytogenetics. Cancer 2004. © 2004 American Cancer Society.
📜 SIMILAR VOLUMES
In contrast to the effects seen in younger adults, depressed elderly subjects have shown more modest antidepressant responses to transcranial magnetic stimulation (TMS). We theorized that higher stimulation intensities in older depressed subjects with prefrontal atrophy might be needed to stimulate
## Background: This study was conducted to determine long term survival rates and the pattern of failure in patients with carcinoma of the oral cavity treated with induction chemotherapy or preoperative radiotherapy followed by surgery. ## Methods: A retrospective analysis was performed of 141 el
## Abstract Background: We report a multi‐institutional experience with intravascular stenting (IS) for treatment of coarctation of the aorta. Methods and Results: Data was collected retrospectively by review of medical records from 17 institutions. The data was broken down to prior to 2002 and aft