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

Affiliations
  • 1Department of Internal Medicine, Inha University Hospital, Inha University, Incheon, Korea.
  • 2Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
  • 3Department of Internal Medicine, Hallym University Medical Center, Hallym University, Anyang, Korea.
  • 4Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Bucheon, Korea.
  • 5Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea. drjin@catholic.ac.kr

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

  • 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.

  • 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.

  • 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).


Cited by  2 articles

How old is old: the beginning of a new era for therapeutic challenges for elderly patients with AML
Hee-Je Kim
Blood Res. 2014;49(2):75-76.    doi: 10.5045/br.2014.49.2.75.

Real-World Treatment Patterns and Clinical Outcomes in Korean Patients With AML Ineligible for First-Line Intensive Chemotherapy: A Subanalysis of the CURRENT Study, a Non-Interventional, Retrospective Chart Review
Soo-Mee Bang, Ka-Won Kang, Ik-Chan Song, Cynthia Llamas, Yinghui Duan, Ji-Young Jeong, Je-Hwan Lee
J Korean Med Sci. 2023;38(44):e345.    doi: 10.3346/jkms.2023.38.e345.


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