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International Journal of Hematology

, Volume 100, Issue 2, pp 141–151 | Cite as

Role of induction and consolidation chemotherapy in elderly acute myeloid leukemia patients

  • Soo-Jeong Kim
  • June-Won Cheong
  • Dae-Young Kim
  • Je-Hwan Lee
  • Kyoo-Hyung Lee
  • Yeo-Kyeoung Kim
  • Hyeong-Joon Kim
  • Ik-Chan Song
  • Deog-Yeon Jo
  • Jeong-Ok Lee
  • Soo-Mee Bang
  • Jinny Park
  • Jae Hoon Lee
  • Won-Sik Lee
  • Young-Don Joo
  • Chi Hoon Maeng
  • Hwi-Joong Yoon
  • Na-Ri Lee
  • Jae-Yong Kwak
  • Kyoung Ha Kim
  • Jong-Ho Won
  • Bo Ram Han
  • Dae Young Zang
  • Joon Ho Moon
  • Sang Kyun Sohn
  • Sung Hwa Bae
  • Hun Mo Ryoo
  • Sung-Yong Kim
  • Mark Hong Lee
  • Yoo Hong MinEmail author
  • The Korean Society of Hematology AML/MDS Working Party
Original Article

Abstract

The present study sought to elucidate the role of induction and consolidation therapy in elderly patients. We retrospectively collected data of 477 patients who were aged over 60 years at the time of acute myeloid leukemia (AML) diagnosis. The median overall survival (OS) was 339 days in the induction group (n = 266) and 86 days in the best supportive care group (n = 211) (P < 0.001). In the induction group, the complete remission (CR) rate was 58.3 %, and treatment-related death was 15.4 %. Successful induction was related to good performance [Eastern Cooperative Oncology Group (ECOG <2)] [hazard ratio (HR) 3.215; P = 0.002]. Mortality correlated with failure to achieve CR (HR 4.059; P < 0.001) and poor performance status (ECOG >2) (HR 2.731; P = 0.035). In CR patients, poor karyotype and absence of consolidation (HR 2.313; P = 0.003) correlated with mortality. More than one cycle of consolidation was associated with better OS (P < 0.001). Lack of salvage therapy was associated with mortality in patients who did not achieve CR (HR 3.223; P = 0.005). Intensive induction in patients with good performance and >1 cycle of consolidation after CR may be the best strategy for improving OS in elderly AML patients.

Keywords

Elderly AML Induction Consolidation 

Notes

Conflict of interest

All authors have no financial conflict of interest with company for this investigation to declare.

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Copyright information

© The Japanese Society of Hematology 2014

Authors and Affiliations

  • Soo-Jeong Kim
    • 1
  • June-Won Cheong
    • 1
  • Dae-Young Kim
    • 2
  • Je-Hwan Lee
    • 2
  • Kyoo-Hyung Lee
    • 2
  • Yeo-Kyeoung Kim
    • 3
  • Hyeong-Joon Kim
    • 3
  • Ik-Chan Song
    • 4
  • Deog-Yeon Jo
    • 4
  • Jeong-Ok Lee
    • 5
  • Soo-Mee Bang
    • 5
  • Jinny Park
    • 6
  • Jae Hoon Lee
    • 6
  • Won-Sik Lee
    • 7
  • Young-Don Joo
    • 7
  • Chi Hoon Maeng
    • 8
  • Hwi-Joong Yoon
    • 8
  • Na-Ri Lee
    • 9
  • Jae-Yong Kwak
    • 9
  • Kyoung Ha Kim
    • 10
  • Jong-Ho Won
    • 10
  • Bo Ram Han
    • 11
  • Dae Young Zang
    • 11
  • Joon Ho Moon
    • 12
  • Sang Kyun Sohn
    • 12
  • Sung Hwa Bae
    • 13
  • Hun Mo Ryoo
    • 13
  • Sung-Yong Kim
    • 14
  • Mark Hong Lee
    • 14
  • Yoo Hong Min
    • 1
    Email author
  • The Korean Society of Hematology AML/MDS Working Party
  1. 1.Division of Hematology, Department of Internal MedicineYonsei University College of Medicine, Severance HospitalSeoulRepublic of Korea
  2. 2.Department of Internal Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  3. 3.Department of Hematology-OncologyChonnam National University Hwasun HospitalHwasunRepublic of Korea
  4. 4.Department of Internal MedicineChungnam National University HospitalDaejeonRepublic of Korea
  5. 5.Department of Internal MedicineSeoul National University Bundang HospitalSeongnamRepublic of Korea
  6. 6.Division of Hematology and Oncology, Department of Internal MedicineGachon University Gil HospitalIncheonRepublic of Korea
  7. 7.Department of Hemato/Oncology, College of MedicineInje UniversityBusanRepublic of Korea
  8. 8.Department of Hematology-Oncology, College of MedicineKyung Hee University SeoulSeoulRepublic of Korea
  9. 9.Department of Internal MedicineChonbuk National University Medical SchoolJeonjuRepublic of Korea
  10. 10.Division of Hematology-Oncology, Department of Internal MedicineSoonchunhyang University College of MedicineSeoulKorea
  11. 11.Division of Hematology-Oncology, Hallym University Medical CenterHallym University College of MedicineSeoulRepublic of Korea
  12. 12.Department of Hematology and Medical OncologyKyungpook National University HospitalDaeguRepublic of Korea
  13. 13.Department of Hematology-Oncology, Deagu Catholic Medical CenterCatholic University of Daegu School of MedicineDeaguKorea
  14. 14.Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical CenterKonkuk University School of MedicineSeoulRepublic of Korea

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