Analysis of Treatment Failure in Acute Nonlymphocytic Leukemia Patients over Fifty Years of Age

Ryan, Donna H.; Kopecky, Kenneth J.; Head, David R.; Grever, Michael R.; Shiaer, Stephen M.; Lipschitz, David A.; Hynes, Harry E.; Vial, R; Veith, Robert; Gumbart, Conrad H.

doi:10.1097/00000421-199202000-00013

Cited by 13 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Older patients with leukemia do not tolerate intensive treatment well and have poor outcomes, [26][27][28] often because of coexisting medical conditions and age-related end-organ or immune dysfunction. Recent studies show that the poor outcome in older patients with leukemia is also related to specific biologic characteristics: a high frequency of unfavorable cytogenetic factors, increased expression of the MDR1 protein, and functional efflux of chemotherapeutic drugs from the leukemic cells.…”

Section: Discussionmentioning

confidence: 99%

Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials

et al. 1999

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials

et al. 1999

View full text Add to dashboard Cite

show abstract

“…For example, it is important that participants in trials that use nephrotoxic chemotherapies have normal renal function. 32, 33 In addition, specific biologic characteristics in older patients can be associated with poor outcomes, 34 and there is evidence that hematologic, cardiac, gastrointestinal, and neurologic toxicity related to chemotherapy may be more severe in older patients. Comorbidity also can affect survival, and elderly patients with comorbid conditions may be more likely to die of causes other than the cancer being treated, making treatment effects more difficult to detect.…”

Section: Discussionmentioning

confidence: 99%

Participation of Patients 65 Years of Age or Older in Cancer Clinical Trials

Lewis

Kilgore

Goldman

et al. 2003

JCO

957

588

View full text Add to dashboard Cite

The elderly are underrepresented in cancer clinical trials relative to their disease burden. Older patients are more likely to have medical histories that make them ineligible for clinical trials because of protocol exclusions. Insurance coverage for clinical trials is one step toward improvement of elderly access to clinical trials. Without a change in study design or requirements, this step may not be sufficient.

show abstract

“…[2][3][4][5] Why do older patients with AML have such a poor prognosis? Older AML patients may be relatively "undertreated" compared to younger patients, 2 or there may be significant differences between the molecular biology of AML in older patients and younger patients.…”

Section: Introductionmentioning

confidence: 99%

FLT3, RAS, and TP53 mutations in elderly patients with acute myeloid leukemia

Stirewalt

Kopecky

Meshinchi

et al. 2001

Blood

Self Cite

373

269

View full text Add to dashboard Cite

The prevalence and significance of genetic abnormalities in older patients with acute myeloid leukemia (AML) are unknown. Polymerase chain reactions and single-stranded conformational polymorphism analyses were used to examine 140 elderly AML patients enrolled in the Southwest Oncology Group study 9031 for FLT3, RAS, and TP53 mutations, which were found in 34%, 19%, and 9% of patients, respectively. All but one of the FLT3 (46 of 47) mutations were internal tandem duplications (ITDs) within exons 11 and 12. In the remaining case, a novel internal tandem triplication was found in exon 11. FLT3 ITDs were associated with higher white blood cell counts, higher peripheral blast percentages, normal cytogenetics, and less disease resistance. All RAS mutations (28 of 28) were missense point mutations in codons 12, 13, or 61. RAS mutations were associated with lower peripheral blast and bone marrow blast percentages. Only 2 of 47 patients with FLT3 ITDs also had a RAS mutation, indicating a significant negative association between FLT3 and RAS mutations (P ‫؍‬ .0013). Most TP53 mutations (11 of 12) were missense point mutations in exons 5 to 8 and were associated with abnormal cytogenetics, especially abnormalities in both chromosomes 5 and 7. FLT3 and RAS mutations were not associated with inferior clinical outcomes, but TP53 mutations were associated with a worse overall survival (median 1 versus 8 months, P ‫؍‬ .0007). These results indicate that mutations in FLT3, RAS, or TP53 are common in older patients with AML and are associated with specific AML phenotypes as defined by laboratory values, cytogenetics, and clinical outcomes.

show abstract

Analysis of Treatment Failure in Acute Nonlymphocytic Leukemia Patients over Fifty Years of Age

Cited by 13 publications

References 0 publications

Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials

Underrepresentation of Patients 65 Years of Age or Older in Cancer-Treatment Trials

Participation of Patients 65 Years of Age or Older in Cancer Clinical Trials

FLT3, RAS, and TP53 mutations in elderly patients with acute myeloid leukemia

Contact Info

Product

Resources

About