ACUTE LYMPHOCYTIC-LEUKEMIA (ALL) IN ELDERLY PATIENTS

Objective: To compare the clinical and biologic characteristics, response to therapy and outcome of adult patients with ALL above and below the age of 55. Design: Retrospective review of clinical and laboratory data. Setting: University affiliated Cancer Center and Veteran's Hospital. Patients: Thirty-three newly diagnosed, consecutive, adults with ALL seen over a nine-year period. Results: while no differences were demonstrated in the distribution of recognized prognostic indicators (such as cytogenetic abnormalities or immunophenotype), individuals over the age of 55 had significantly lower remission rates and shorter survivals. Conclusions: The outcome of elderly patients with ALL is very poor. This is primarily related to an increase in the number of early deaths during induction, as well as a higher prevalence of disease refractory to standard chemotherapy programmes. There is a need for new treatment protocols designed for the elderly ALL patient, as well as a better understanding of the unique biological characteristics of the disease in this age group.