Leukemia in patients more than seventy years old

The characteristics of leukemia in elderly patients, especially acute nonlymphocytic leukemia, and therapy are reviewed. The features differ little from those in young ANLL patients, except for the frequencies of the preleukemic state and poor performance status. Preleukemic states are observed in about 30% of elderly patients and about 40% of the elderly patients have a poor performance status on admission. Anthracycline and Ara-C are generally used for the treatment of ANLL in elderly patients. Many reports suggest identifying a group of patients with favourable prognostic factors and treating them intensively. However, the prognostic factors reported were variable. A good performance status and normal- or hypocellular bone marrow were the most important prognostic factors in our study. Low dose Ara-C may be effective in ANLL in elderly patients with hypoplastic bone marrows. Supportive care is also very important in elderly patients.