Korean J Intern Med.  2011 Sep;26(3):328-339. 10.3904/kjim.2011.26.3.328.

Acute Lymphoblastic Leukemia in Elderly Patients: A Single Institution's Experience

• Shin DY
• Kim I
• Kim KH
• Choi Y
• Beom SH
• Yang Y
• Lim Y
• Lee E
• Lee JK
• Kim JY
• Kim HK
• Yoon SS
• Lee DS
• Park S
• Kim BK

• KMID: 1022173
• DOI: http://doi.org/10.3904/kjim.2011.26.3.328

Abstract

BACKGROUND/AIMS
We investigated the clinical characteristics and prognosis of elderly patients with acute lymphoblastic leukemia (ALL).
METHODS
We reviewed the clinical data, laboratory findings, bone marrow findings, and cytogenetic analysis of elderly patients (> or = 60 years) with ALL, and data of an additional 101 younger adult patients (< 60 years) with ALL were reviewed for comparison.
RESULTS
Twenty-six elderly patients (> or = 60 years) and 101 younger adult patients (< 60 years) with ALL were retrospectively enrolled. The median follow-up duration was 6.0 months (range, 0.4 to 113.2) in the elderly patients and 21.7 months (range, 1.0 to 122.7) in the adult patients. In total, 34.6% (9 patients) of the elderly patients and 24.8% (25 patients) of the adult patients had Philadelphia chromosome positive ALL. The overall complete remission (CR) rate was much higher in the younger than in the elderly patients (94.1% vs. 57.7%, p < 0.001). The median overall survival (OS) of the younger patients (< 60 years) was 26.3 months, whereas that of the elderly patients (> or = 60 years) was 10.3 months (p = 0.003). In the elderly patients with ALL, T cell lineage and the presence of lymphadenopathy were significant prognostic factors for OS in a univariate analysis (p = 0.033 and 0.041, respectively).
CONCLUSIONS
The outcomes of Korean elderly patients with ALL were poor, and the shorter OS was mainly due to the low CR rate. T-cell lineage and the presence of lymphadenopathy were significant prognostic factors in Korean elderly patients with ALL.

Keyword

Leukemia, lymphoid; Aged; Prognosis; Philadelphia chromosome

MeSH Terms

Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Bone Marrow Examination
Chi-Square Distribution
Disease-Free Survival
Female
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Philadelphia Chromosome
*Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis/drug therapy/genetics/immunology/mortality
Proportional Hazards Models
Remission Induction
Republic of Korea
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
Young Adult