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Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry

Juliusson, Gunnar LU ; Antunovic, Petar; Derolf, Asa; Lehmann, Soren; Mollgard, Lars; Stockelberg, Dick; Tidefelt, Ulf; Wahlin, Anders and Hoglund, Martin (2009) In Blood 113(18). p.4179-4187
Abstract
Acute myeloid leukemia (AML) is most common in the elderly, and most elderly are thought to be unfit for intensive treatment because of the risk of fatal toxicity. The Swedish Acute Leukemia Registry covers 98% of all patients with AML (non-acute promyelocytic leukemia) diagnosed in 1997 to 2005 (n = 2767), with a median follow-up of 5 years, and reports eligibility for intensive therapy, performance status (PS), complete remission rates, and survival. Outcomes were strongly age and PS dependent. Early death rates were always lower with intensive therapy than with palliation only. Long-term survivors were found among elderly given intensive treatment despite poor initial PS. Total survival of elderly AML patients was better in the... (More)
Acute myeloid leukemia (AML) is most common in the elderly, and most elderly are thought to be unfit for intensive treatment because of the risk of fatal toxicity. The Swedish Acute Leukemia Registry covers 98% of all patients with AML (non-acute promyelocytic leukemia) diagnosed in 1997 to 2005 (n = 2767), with a median follow-up of 5 years, and reports eligibility for intensive therapy, performance status (PS), complete remission rates, and survival. Outcomes were strongly age and PS dependent. Early death rates were always lower with intensive therapy than with palliation only. Long-term survivors were found among elderly given intensive treatment despite poor initial PS. Total survival of elderly AML patients was better in the geographic regions where most of them were given standard intensive therapy. This analysis provides unique real world data from a large, complete, and unselected AML population, both treated and untreated, and gives background to treatment decisions for the elderly. Standard intensive treatment improves early death rates and long-term survival compared with palliation. Most AML patients up to 80 years of age should be considered fit for intensive therapy, and new therapies must be compared with standard induction. (Blood. 2009; 113: 4179-4187) (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Blood
volume
113
issue
18
pages
4179 - 4187
publisher
American Society of Hematology
external identifiers
  • wos:000265846300013
  • pmid:19008455
  • scopus:66149148673
ISSN
1528-0020
DOI
10.1182/blood-2008-07-172007
language
English
LU publication?
yes
id
53245efd-3d19-422e-bf22-325ca0b24304 (old id 1426433)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19008455?dopt=Abstract
date added to LUP
2009-06-29 14:53:53
date last changed
2017-12-10 03:50:05
@article{53245efd-3d19-422e-bf22-325ca0b24304,
  abstract     = {Acute myeloid leukemia (AML) is most common in the elderly, and most elderly are thought to be unfit for intensive treatment because of the risk of fatal toxicity. The Swedish Acute Leukemia Registry covers 98% of all patients with AML (non-acute promyelocytic leukemia) diagnosed in 1997 to 2005 (n = 2767), with a median follow-up of 5 years, and reports eligibility for intensive therapy, performance status (PS), complete remission rates, and survival. Outcomes were strongly age and PS dependent. Early death rates were always lower with intensive therapy than with palliation only. Long-term survivors were found among elderly given intensive treatment despite poor initial PS. Total survival of elderly AML patients was better in the geographic regions where most of them were given standard intensive therapy. This analysis provides unique real world data from a large, complete, and unselected AML population, both treated and untreated, and gives background to treatment decisions for the elderly. Standard intensive treatment improves early death rates and long-term survival compared with palliation. Most AML patients up to 80 years of age should be considered fit for intensive therapy, and new therapies must be compared with standard induction. (Blood. 2009; 113: 4179-4187)},
  author       = {Juliusson, Gunnar and Antunovic, Petar and Derolf, Asa and Lehmann, Soren and Mollgard, Lars and Stockelberg, Dick and Tidefelt, Ulf and Wahlin, Anders and Hoglund, Martin},
  issn         = {1528-0020},
  language     = {eng},
  number       = {18},
  pages        = {4179--4187},
  publisher    = {American Society of Hematology},
  series       = {Blood},
  title        = {Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry},
  url          = {http://dx.doi.org/10.1182/blood-2008-07-172007},
  volume       = {113},
  year         = {2009},
}