Age and acute myeloid leukemia

被引:1056
作者
Appelbaum, FR
Gundacker, H
Head, DR
Slovak, ML
Willman, CL
Godwin, JE
Anderson, JE
Petersdorf, SH
机构
[1] SW Oncol Grp, Operat Off, Ctr Stat, San Antonio, TX 78245 USA
[2] Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA
[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA
[4] City Hope Natl Med Ctr, Duarte, CA 91010 USA
[5] Univ New Mexico, Albuquerque, NM 87131 USA
[6] Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA
[7] Katmai Oncol Grp, Anchorage, AK USA
[8] Seattle Canc Care Alliance, Seattle, WA USA
关键词
D O I
10.1182/blood-2005-09-3724
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We conducted a retrospective analysis of 968 adults with acute myelold leukemia (AML) on 5 recent Southwest Oncology Group trials to understand how the nature of AML changes with age. Older study patients with AML presented with poorer performance status, lower white blood cell counts, and a lower percentage of marrow blasts. Multidrug resistance was found in 33% of AMLs in patients younger than age 56 compared with 57% in patients older than 75. The percentage of patients with favorable cytogenetics dropped from 1r/6 in those younger than age 56 to 4% in those older than 75. In contrast, the proportion of patients with unfavorable cytogenetics increased from 35% In those younger than age 56 to 51% in patients older than 75. Particularly striking were the Increases In abnormalities of chromosomes 5, 7, and 17 among the elderly. The Increased incidence of unfavorable cytogenetics contributed to their poorer outcome, and, within each cytogenetic risk group, treatment outcome datedonated markedly with age. Finally, the combination of a poor performance status and advanced age identified a group of patients with a very high likelihood of dying within 30 days of initiating induction therapy. The distinct biology and clinical responses seen argue for age-specific assessments when evaluating therapies for AML.
引用
收藏
页码:3481 / 3485
页数:5
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