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Acute Myeloid Leukaemia

Optimising Treatment in Elderly Patients

  • Therapy In Practice
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Abstract

Acute myeloid leukaemia (AML) is a disease of the elderly (median age at presentation 64 years). The outcome in older patients with AML is much worse than that for similarly treated younger patients. Older patients have a high incidence of recognised poor prognostic features (poor performance status, unfavourable cytogenetics, CD34 positive phenotype, raised serum lactate dehydrogenase levels and increased incidence of multidrug resistance protein expression). In addition, treatment is less well tolerated as there is an increased incidence of comorbidity in the elderly.

The outlook for most patients is poor (4% survival at 5 years). However, it is possible to select a group of patients who are fit, with no pre-existing problems and good performance status who will respond well to intensive chemotherapy, and these patients should be treated aggressively. Less intensive treatment is probably more suitable for patients not fitting these criteria. Patients and their relatives should be counselled appropriately as to the prognosis of AML, the choices of treatment available and that intensive regimens are not an appropriate choice for many patients.

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Acknowledgements

Dr Taylor is funded by a grant from the R & D Department of the Northern and Yorkshire Health Region, UK. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

The authors would like to thank Jane Lord for secretarial support.

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  1. Department of Haematology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne, NE1 4LP, UK

    Graham H. Jackson & Penelope R. A. Taylor

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  1. Graham H. Jackson
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  2. Penelope R. A. Taylor
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Correspondence to Graham H. Jackson.

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Jackson, G.H., Taylor, P.R.A. Acute Myeloid Leukaemia. Drugs Aging 19, 571–581 (2002). https://doi.org/10.2165/00002512-200219080-00003

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