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

Authors
 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 Min 
Citation
 INTERNATIONAL JOURNAL OF HEMATOLOGY, Vol.100(2) : 141-151, 2014 
Journal Title
 INTERNATIONAL JOURNAL OF HEMATOLOGY 
ISSN
 0925-5710 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols* ; Consolidation Chemotherapy/methods* ; Cytarabine/administration & dosage ; Daunorubicin/administration & dosage ; Female ; Humans ; Idarubicin/administration & dosage ; Karyotyping ; Leukemia, Myeloid, Acute/drug therapy* ; Leukemia, Myeloid, Acute/mortality ; Leukemia, Myeloid, Acute/pathology ; Male ; Middle Aged ; Remission Induction ; Retrospective Studies ; Salvage Therapy ; Survival Analysis ; Treatment Outcome ; Vidarabine/administration & dosage ; Vidarabine/analogs & derivatives
Keywords
Elderly AML ; Induction ; Consolidation
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.
Full Text
http://link.springer.com/article/10.1007%2Fs12185-014-1617-8
DOI
10.1007/s12185-014-1617-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99701
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