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

På svenska

Author

  • Gunnar Juliusson
  • R Billstrom
  • A Gruber
  • E Hellstrom-Lindberg
  • M Hoglund
  • K Karlsson
  • D Stockelberg
  • A Wahlin
  • M Astrom
  • C Arnesson
  • U Brunell-Abrahamsson
  • J Carstensen
  • E Fredriksson
  • E Holmberg
  • K Nordenskjold
  • F Wiklund
Show all

Summary, in English

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.

Publishing year

2006

Language

English

Pages

42-47

Publication/Series

Leukemia

Volume

20

Issue

1

Document type

Journal article

Publisher

Nature Publishing Group

Topic

  • Cancer and Oncology

Keywords

  • acute myeloid leukemia
  • elderly
  • remission induction
  • population based
  • palliation

Status

Published

ISBN/ISSN/Other

  • ISSN: 1476-5551