Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 6724
© 2005 American Society of Clinical Oncology

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Abstract

Treatment outcomes in elderly patients ( 60 years) with acute myeloid leukemia (AML) and refractory anemia with excess blasts (RAEB) with intensive chemotherapy: A retrospective single center analysis

Seton Hall Univ, Paterson, NJ; Seton Hall Univ, South Orange, NJ; St. Joseph’s Regional Medcl Ctr, Paterson, NJ

6724

Background: The diagnosis of AML or RAEB in the elderly infers a short survival. Then median survival of elderly patients with AML treated with chemotherapy is approximately 7 months, and those with RAEB is 12 months. Methods: Records of all elderly patients with AML or RAEB who received intensive chemotherapy at our institution since March 2002 were reviewed for prognostic factors, treatment response and overall survival. Results: Seventeen elderly patients (AML- 14, RAEB- 3) were identified. There were 8 males and 9 females. The median age was 68(range of 60–83) years. Seven (41.1%) had poor risk cytogenetics, 8(47.1%) had intermediate risk, and 2 (11.8%)had unknown risk. Patients underwent induction chemotherapy with the following regimens: high dose cytarabine (HIDAC)/ mitoxantrone -13 patients, 7+3 -2 patients, HIDAC/ topetecan -1 patient, HIDAC/ daunorubicin -1 patient. Thirteen (76.5%) patients achieved a complete remission (CR). Of these patients, 11 (64.7%) patients had a morphologic CR (CRm) and 2 (11.8%) patients achieved CR with inadequate count recovery (CRi). Three patients out of 11 with cytogenetic abnormalities achieved a cytogenetic CR (CRc). There was one (5.9%) induction related mortality. Two patients (11.8%)had persistent disease post induction. Thirteen patients received a HIDAC based second round of chemotherapy and one went directly to allogeneic stem cell transplant (SCT); all achieved a type of CR (CRm - 11 pts, CRi - 3 pts). Eight patients received a third round of intense therapy (2- chemotherapy, 4- autologous SCT, 2- mini- allogeneic SCT). Median survival from first day of chemotherapy was 496 days (range 13- 880). Kaplan-Meier estimate of one-year survival of fifteen patients (1 patient censored at 74 and 79 days) is 68.63% (SE 11.74%). Two year Kaplan-Meier estimate of survival of ten patients (1 patient censored at 74, 79, 243, 370, 494, 581, and 879 days) is 31.37% (SE 14.04%). All censored patients are alive and continued to be followed. Conclusions: Our experience shows that aggressive treatment of AML and RAEB in the elderly can produce longer survivals than previously reported.

No significant financial relationships to disclose.