Acute Nonlymphoblastic Leukemia: Treatment of Elderly Patients

Forty-six elderly patients with acute non lymphoblastic leukemia (ANLL) were treated with a low toxicity drug combination (Oncovin, low dose Ara-C and Prednisone (OAP)) or with much more aggressive regimens. Complete remission was achieved in 6/23 patients treated with OAP and in 9/23 with aggressive chemotherapy (AC). The mean duration of remission was 18 and 27 weeks, respectively. Ten patients in the first group and 5 patients in the second group were resistant to therapy. During OAP treatment, 7 patients died, 6 during the induction phase and 1 in the consolidation phase, while 9 patients in the group treated aggressively died during the induction phase We conclude that aggressive regimens may be used in well selected elderly patients while patients with severe preexisting medical diseases may be treated with less aggressive drug combination.