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Published on: March 5, 2018
[Treatment results for unselected patients with acute myelogenous leukemia. During a 10-year period, August 1984 to
1Department of Internal Medicine, Fujita Health University School of Medicine.
Insights
This study analyzed 129 acute myelogenous leukemia patients over 10 years. Intensive chemotherapy improved outcomes for eligible patients, highlighting the need for better management strategies for elderly patients.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- Acute myelogenous leukemia (AML) is a complex hematologic malignancy.
- Understanding clinical characteristics and outcomes is crucial for treatment optimization.
- Patient selection for intensive chemotherapy significantly impacts survival rates.
Purpose of the Study:
- To analyze the clinical characteristics and outcomes of adult patients with acute myelogenous leukemia.
- To evaluate the efficacy of intensive chemotherapy in eligible AML patients.
- To identify factors influencing survival and disease-free survival in AML.
Main Methods:
- Retrospective analysis of 129 consecutive adult AML patients over a 10-year period (August 1984 - July 1994).
- Patients were categorized based on eligibility for intensive chemotherapy (cure-oriented).
- Clinical data, including age, antecedent myelodysplastic syndrome (MDS), secondary leukemia, and concurrent diseases, were collected.
Main Results:
- Median survival for all 129 patients was 441 days, with a 5-year actuarial survival of 28.6%.
- Disease-free survival (DFS) decreased with increasing patient age.
- In 78 eligible patients, complete remission was 84.6%, with a 5-year DFS of 41.1%, demonstrating superior outcomes compared to ineligible patients.
Conclusions:
- Intensive chemotherapy offers significant survival benefits for eligible acute myelogenous leukemia patients.
- Patient age and secondary leukemia diagnoses are critical factors affecting treatment eligibility and outcomes.
- Further analysis of unselected patient data is needed to develop effective management strategies for elderly AML patients.
Abstract:
In order to analyse the clinical characteristics and outcome in acute myelogenous leukemia, 129 consecutive adult patients admitted to our hospital over a 10-year period, from August 1984 to July 1994, were studied. Their median age was 51 years, 17 (13.2%) of them had antecedent myelodysplastic syndrome (MDS) and 9 (7.0%) had secondary leukemia. Seventy-eight patients (60.5%) were considered eligible for cure-oriented intensive chemotherapy. Forty-four patients were ineligible of one or more of the following; age over 70, antecedent MDS or secondary leukemia. Additional 7 patients were excluded due to concurrent severe diseases. The median survival of the 129 patients was 441 days with an actuarial 5-year survival of 28.6 +/- 4.4%, and the disease-free survival (DFS) decreased with the increasing age of the patient. In 78 patients who were eligible for intensive chemotherapy, complete remission was achieved in 84.6% and overall DFS was 41.1 +/- 5.9% at 5 years, and their survival was longer than that of ineligible patients. It was suggested that considerable selection of patients, for example, due to old age, already existed before visiting our hospital. Analysis of clinical data of unselected patients might enable the development of a rational approach to the management of elderly patients.
