Acute Leukaemia in the Elderly, Remission Induction Versus Palliative Therapy

Smith, Alastair G.; Whitehouse, J. M. A.; Roath, O.S.; Cj, Williams; Mead, G. M.

doi:10.1007/978-3-642-71213-5_51

Cited by 2 publications

(3 citation statements)

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“…Many patients are unable to withstand intensive chemotherapy because of concurrent medical and social problems (Smith et al, 1987). In this series of 54 consecutive patients aged 60 years and above, only 26 were considered suitable for combination chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…The age and clinical state of a patient with AML are important factors in determining the response to treatment and survival (Bernard et al, 1984;Beguin et al, 1985;. Many patients are unable to withstand intensive chemotherapy because of concurrent medical and social problems (Smith et al, 1987). In this series of 54 consecutive patients aged 60 years and above, only 26 were considered suitable for combination chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of acute myeloid leukemia in the elderly: A clinical dilemma

Copplestone

Smith

Osmond

et al. 1989

Hematological Oncology

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Fifty-four patients representing all the cases of acute myeloid leukemia in patients aged over 60 years, presenting to three adjacent hospitals, were studied. Only 26 of the 54 patients were considered suitable for remission induction with intensive combination chemotherapy which produced seven complete remissions (CR) (26 per cent). Eighteen of the 54 patients survived longer than three months--11 of these had received remission induction chemotherapy (five CRs), two low dose cytarabine, one vincristine and vitamin A and four supportive treatment alone. By six months all the patients who had received supportive treatment had died. Patients who received intensive chemotherapy spent 77 per cent of the first 90 days in hospital and half died in hospital. Patients receiving differentiating agents or supportive care spent more time at home (37 per cent, 34 per cent of the first 90 days, respectively) but had shorter overall survival. Assessment of clinical characteristics in an attempt to predict response to treatment and survival indicated that poor performance status and the presence of infection were the most important factors. Analysis was limited by the statistically small number in the group. At present there is no reliable method of predicting which patients will respond well to treatment with intensive chemotherapy. The clinical dilemma is whether to treat more intensively to benefit a minority, or to use supportive treatment to allow more time to be spent at home albeit with a shorter overall survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Treatment of acute myeloid leukemia in the elderly: A clinical dilemma

Copplestone

Smith

Osmond

et al. 1989

Hematological Oncology

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“…The results of treat ment of elderly AML patients were much inferior to those obtained in young patients [19][20][21]. Why elderly AML patients fare less well may also be due to dif ferences in their leukaemic cells [22].…”

Section: Discussionmentioning

confidence: 99%

Relation between Age and Blast Cell Differentiation in Acute Myeloid Leukaemia Patients

Hassan

Rees²

1990

Oncology

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The relation between age and the cytological and cytochemical features of blast cell differentiation in 211 patients with primary acute myeloid leukaemia (AML) was investigated. Five cytological and cytochemical features of blast cell differentiation – the presence of Auer rods, the presence of granules, low nuclear/cyto-plasmic ratio, Sudan black positivity and the maturation index – were studied in bone marrow smears of each AML patient. The results showed significantly more AML cases with both cytological and cytochemical features of blast cell differentiation in young patients (<60 years old) than in elderly patients (>60 years old). These findings support the existence of two forms of primary AML: one more frequently detected in younger patients with more differentiated blast cells and the second with less differentiated blast cells mainly found in elderly patients.

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Acute Leukaemia in the Elderly, Remission Induction Versus Palliative Therapy

Cited by 2 publications

References 4 publications

Treatment of acute myeloid leukemia in the elderly: A clinical dilemma

Treatment of acute myeloid leukemia in the elderly: A clinical dilemma

Relation between Age and Blast Cell Differentiation in Acute Myeloid Leukaemia Patients

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