Acute lymphoblastic leukemia in elderly patients: a single institution's experience

Area of Science:

• Hematology
• Oncology
• Geriatrics

Background:

• Acute lymphoblastic leukemia (ALL) disproportionately affects older adults, presenting unique clinical challenges.
• Understanding the specific characteristics and prognostic factors in elderly ALL patients is crucial for improving outcomes.
• Limited data exists on the clinical course and survival of elderly patients with ALL, particularly in specific ethnic cohorts.

Purpose of the Study:

• To investigate the clinical features and prognosis of elderly patients diagnosed with acute lymphoblastic leukemia (ALL).
• To compare the outcomes of elderly ALL patients with those of younger adult patients.
• To identify significant prognostic factors influencing overall survival in elderly ALL patients.

Main Methods:

• Retrospective review of clinical data, laboratory findings, bone marrow morphology, and cytogenetic analysis.
• Inclusion of 26 elderly patients (≥ 60 years) with ALL.
• Comparison group comprised 101 younger adult patients (< 60 years) with ALL.

Main Results:

• Elderly ALL patients exhibited a significantly lower complete remission (CR) rate (57.7%) compared to younger patients (94.1%).
• Median overall survival (OS) was substantially shorter in elderly patients (10.3 months) versus younger patients (26.3 months).
• Philadelphia chromosome positivity was observed in 34.6% of elderly and 24.8% of younger patients.
• Univariate analysis identified T-cell lineage and lymphadenopathy as significant negative prognostic factors for OS in elderly ALL patients.

Conclusions:

• Korean elderly patients with ALL demonstrate poor clinical outcomes, primarily attributed to a lower CR rate.
• Shorter overall survival in this cohort is linked to reduced treatment efficacy and potentially disease-specific factors.
• T-cell lineage and the presence of lymphadenopathy are identified as critical prognostic indicators for elderly ALL patients.