Work

Acute Myelogenous Leukemia and Aging

Year: 2000

Type: article

Abstract: Acute myelogenous leukemia (AML) is a devastating disease that afflicts the elderly more frequently than the young. Ironically, many of the recent therapeutic advances are not deemed suitable for the very population of patients that suffers most from this illness. This point raises competing issues. On one hand, the effect of modern therapy for AML in the elderly may be skewed by the underrepresentation of the elderly in clinical trials. Indeed, Ferrara showed that only 55% of patients over the age of 60 years were enrolled in clinical trials, as compared with more than 90% of younger patients.12 In leukemia, specifically, less than 10% of clinical trial participants were older than 65 years, even though this cohort represents more than 55% of patients with leukemia.65 On the other hand, elderly patients enrolled in prospective randomized studies may not be representative of the total elderly AML population but may instead represent a cohort of healthier patients. A prospective British study of AML in the elderly found that only 89 of 200 patients newly diagnosed with AML were considered fit enough to receive treatment with curative intent. This finding emphasizes that the elderly are frequently afflicted with comorbidities that preclude aggressive therapy.59 The definition of elderly is difficult to determine, because it involves biologic considerations and chronologic age. Most therapeutic trials in the United States include patients aged 55 years or older in this category. Bone marrow transplantation, whether allogeneic or autologous, rarely is offered to individuals over the age of 60 years. This article does not attempt to define elderly with any degree of precision but includes the age group of 55 to 65 years, the young-old, in the elder category. Certainly, the Medicare definition of elderly (65 years of age or older) is also acceptable. This article reviews the biologic and clinical characteristics of AML in the elderly population and the treatment options that have emerged during the past several years.

Source: Hematology/Oncology Clinics of North America

DOI: 10.1016/s0889-8588(05)70287-2

Authors: Jeffrey E. Lancet, Cheryl L. Willman, John M. Bennett

Institutions: University of Rochester Medicine, University of New Mexico, UNM Comprehensive Cancer Center, University of Rochester

Language: English

Topic: Acute Myeloid Leukemia Research

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,950