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Abstract
27 patients aged over 60 years with acute myelogenous leukemia (AML) were treated with a chemotherapy regimen consisting of a combination of idarubicin (IDA) and cytosine arabinoside (ARA-C) as the induction regimen, with etoposide and 6-thioguanine added in the post-remission phase. Inclusion criteria were no different from those commonly used for younger adults. In 7 cases AML was preceded by a previous myelodysplastic syndrome (MDS). The median age was 68 (range 61–74) and 15 patients (55.5%) achieved complete remission (CR) and in 10 HR CR was achieved after only one course of chemotherapy. All patients in CR experienced profound bone marrow hypoplasia, requiring intensive support.Extrahematological WHO grade 4 toxicity was not observed in any patient. Median disease-free and overall survival for patients in CR was 10 and 14 months, respectively. We conclude that the combination of IDA and ARA-C is highly effective in inducing CR in elderly AML, with acceptable toxicity.