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Attitude towards remission induction for elderly patients with acute myeloid leukemia influences survival.

Juliusson, Gunnar LU ; Billstrom, R; Gruber, A; Hellstrom-Lindberg, E; Hoglund, M; Karlsson, K; Stockelberg, D; Wahlin, A; Astrom, M and Arnesson, C, et al. (2006) In Leukemia 20(1). p.42-47
Abstract
Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking. The remission intention ( RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown. The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries. Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region ( range... (More)
Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking. The remission intention ( RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown. The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries. Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region ( range 36-76%) and the two-year overall survival, with no censored observations (6-21%) ( v 2 for trend = 11.3, P < 0.001; r(2) = 0.86, P < 0.02, nonparametric). A 1-month landmark analysis showed significantly better survival in regions with higher RI rates ( P = 0.003). Differences could not be explained by demographics, and was found in both de novo and secondary leukemias. The 5-year survival of the overall population aged 70-79 years was similar between the regions. Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction. (Less)
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publication status
published
subject
keywords
acute myeloid leukemia, elderly, remission induction, population based, palliation
in
Leukemia
volume
20
issue
1
pages
42 - 47
publisher
Nature Publishing Group
external identifiers
  • wos:000233956600006
  • pmid:16327841
  • scopus:33644985390
ISSN
1476-5551
DOI
10.1038/sj.leu.2404004
language
English
LU publication?
yes
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f1b7fb25-17c2-48cb-8d85-0ed814ff36b3 (old id 148919)
date added to LUP
2007-07-08 07:30:49
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2019-07-30 02:57:49
@article{f1b7fb25-17c2-48cb-8d85-0ed814ff36b3,
  abstract     = {Combination chemotherapy may induce remission from acute myeloid leukemia (AML), but validated criteria for treatment of elderly are lacking. The remission intention ( RI) rate for elderly patients, as reported to the Swedish Leukemia Registry, was known to be different when comparing the six health care regions, but the consequences of different management are unknown. The Leukemia Registry, containing 1672 AML patients diagnosed between 1997 and 2001, with 98% coverage and a median follow-up of 4 years, was completed with data from the compulsory cancer and population registries. Among 506 treated and untreated patients aged 70-79 years with AML (non-APL), there was a direct correlation between the RI rate in each health region ( range 36-76%) and the two-year overall survival, with no censored observations (6-21%) ( v 2 for trend = 11.3, P &lt; 0.001; r(2) = 0.86, P &lt; 0.02, nonparametric). A 1-month landmark analysis showed significantly better survival in regions with higher RI rates ( P = 0.003). Differences could not be explained by demographics, and was found in both de novo and secondary leukemias. The 5-year survival of the overall population aged 70-79 years was similar between the regions. Survival of 70-79-year-old AML patients is better in regions where more elderly patients are judged eligible for remission induction.},
  author       = {Juliusson, Gunnar and Billstrom, R and Gruber, A and Hellstrom-Lindberg, E and Hoglund, M and Karlsson, K and Stockelberg, D and Wahlin, A and Astrom, M and Arnesson, C and Brunell-Abrahamsson, U and Carstensen, J and Fredriksson, E and Holmberg, E and Nordenskjold, K and Wiklund, F},
  issn         = {1476-5551},
  keyword      = {acute myeloid leukemia,elderly,remission induction,population based,palliation},
  language     = {eng},
  number       = {1},
  pages        = {42--47},
  publisher    = {Nature Publishing Group},
  series       = {Leukemia},
  title        = {Attitude towards remission induction for elderly patients with acute myeloid leukemia influences survival.},
  url          = {http://dx.doi.org/10.1038/sj.leu.2404004},
  volume       = {20},
  year         = {2006},
}