Blood Res.  2014 Jun;49(2):95-99. 10.5045/br.2014.49.2.95.

Clinical characteristics and treatment outcome of acute myeloid leukemia in elderly patients in Korea: a retrospective analysis

• Yi HG
• Lee MH
• Kim CS
• Hong J
• Park J
• Lee JH
• Han BR
• Kim HY
• Zang DY
• Kim SH
• Park SK
• Hong DS
• Lee GJ
• Jin JY
• Gyeonggi/Incheon Branch, The Korean Society of Hematology

• KMID: 2172804
• DOI: http://doi.org/10.5045/br.2014.49.2.95

Abstract

BACKGROUND
The clinical characteristics of elderly patients with AML differ from those of younger patients, resulting in poorer survival and treatment outcomes. We analyzed retrospectively the clinical data of AML patients 65 years old and above to describe patients' characteristics and treatment patterns, and to define meaningful prognostic factors of survival in the Korean population.
METHODS
Basic patients' characteristics, clinical outcomes according to treatments, and prognostic factors associated with survival and treatment intensity were examined in a total of 168 patients diagnosed in 5 institutes between 1996 and 2012 as having AML.
RESULTS
Herein, 84 patients (50.0%) received high-intensity regimens (HIR), 18 (10.7%) received low-intensity regimens (LIR), and 66 (39.3%) received supportive care (SC) only. The median survival of all patients was 4.5 months; and median survival times with HIR, LIR, and SC were 6.8 months, 10.2 months, and 1.6 months, respectively. Median survival times with HIR and LIR were significantly longer than that with SC (P<0.0001 and P=0.006, respectively). Multivariate analysis identified age, Eastern Cooperative Oncology Group-performance status (ECOG-PS), hemoglobin (Hb) level, and serum creatinine (Cr) level as statistically significant prognostic factors for survival. In the HIR group, prognostic factors for survival were ECOG-PS, Hb level, and C-reactive protein level.
CONCLUSION
Even in elderly AML patients, an intensive treatment regimen could be beneficial with careful patient selection. Further prospective studies designed to identify specific prognostic factors are required to establish an optimal treatment strategy for elderly AML patients.

Keyword

Acute myeloid leukemia; Survival; Prognosis; Chemotherapy; Elderly

MeSH Terms

Academies and Institutes
Aged*
C-Reactive Protein
Creatinine
Drug Therapy
Humans
Korea
Leukemia, Myeloid, Acute*
Multivariate Analysis
Patient Selection
Prognosis
Retrospective Studies*
Treatment Outcome*
C-Reactive Protein
Creatinine

Figure

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  Fig. 1 (A) The median survival of all patients was 4.5 months (95% CI: 2.4-6.7 months). (B) Kaplan-Meier analysis of overall survival according to the cytogenetic risk group.

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  Fig. 2 (A) Survival comparison according to treatment intensity showed that median survivals in the HIR and LIR groups were significantly longer than that in the SC group. There was no difference in median survival between the HIR and the LIR group. (B) In the intermediate risk group, median survivals in the HIR and LIR groups were significantly longer than that in the SC group (P=0.031). There was no difference in median survival between the HIR and the LIR group. Abbreviations: HIR, high-intensity regimen; LIR, low-intensity regimen; SC, supportive care.

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  Fig. 3 In the high-intensity regimen group, survival of the patients showing complete remission (CR) was significantly longer than that of patients who did not show CR (non-CR) (P<0.0001).

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