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Acute myeloid leukaemia - Optimising treatment in elderly patients

Lookup NU author(s): Professor Graham Jackson, Dr Penelope Taylor


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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 elderily. 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.

Publication metadata

Author(s): Jackson GH, Taylor PRA

Publication type: Article

Publication status: Published

Journal: Drugs & Aging

Year: 2002

Volume: 19

Issue: 8

Pages: 571-581

Print publication date: 01/01/2002

ISSN (print): 1170-229X

ISSN (electronic): 1179-1969

Publisher: Adis International Ltd.


DOI: 10.2165/00002512-200219080-00003


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