[Treatment of acute leukemia in older patients]

The median age of patients with acute leukemia is more than 60 years, and the incidence of the disease increases with age. There are several unfavorable biologic and clinical factors in older patients with acute leukemia, the remission rate and their survival are much worse than in younger adults. The poor performance score and any other concomitant disease and the poor reserve capacity of their bone marrow represent significant difficulties to deliver the proper remission induction and postremission therapy. The poor biologic factors like acute leukemia following myelodysplasia, unfavorable cytogenetic abnormalities and multidrug resistance among elderly patients are more common comparing to younger patients. The authors summarize the international data and attempt to define the proper therapy namely who are candidates for induction and intensive postremission therapy, what is the role of palliative cytostatic treatment or supportive care for these patients.