Therapeutic outcomes of older patients with acute myeloid leukemia

OBJECTIVE: To evaluate the therapeutic outcomes of acute myeloid leukemia (AML) in elderly patients.

METHODS: This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan over 11 years from January 1997 to August 2008. This was a descriptive case series study. We investigated the impact of disease biology and various treatment protocols on the outcome in this population.

RESULTS: A total of 55 evaluable patients (>60 years of age) were diagnosed with AML including 34 (61.8%) males and 21 (38.2%) females. The median age was 67 years (range 60-86 years) at the time of presentation. The AML was preceded by myelodysplastic syndrome in 15 (27.2%) patients. High-risk cytogenetics were observed in 3 (5.4%) patients. Forty patients received palliative treatment while only 15 received chemotherapy. Of the last group with primary AML (n=10), there were 2 remitters, one showed resistant disease while 8 had induction death. The overall mean survival was 75.1 days (95% confidence interval: 46.7-103.5 days) in all patients. There was no survival advantage in patients treated with chemotherapy versus those conservatively treated.

CONCLUSION: We found high mortality among aged patients with AML in our setting. Patients receiving chemotherapy were extremely intolerant to toxic drugs and succumbed earlier than patients receiving palliative care only.