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Leukemia & Lymphoma Volume 56, 2015 - Issue 8
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Original Article

Treatment of elderly patients with acute myeloid leukemia adjusted for performance status and presence of comorbidities: a Polish Adult Leukemia Group study

Bozena Katarzyna BudziszewskaHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland;Center of Postgraduate Medical Education, Warsaw, Poland
,
Agnieszka PlutaHematology Department, Medical University of Lodz, Lodz, Poland
,
Kazimierz SulekHematology Department, Military Medical Institute, Warsaw, Poland
,
Agnieszka WierzbowskaHematology Department, Medical University of Lodz, Lodz, Poland
,
Tadeusz RobakHematology Department, Medical University of Lodz, Lodz, Poland
,
Sebastian GiebelDepartment of Bone Marrow Transplantation, Comprehensive Cancer Center, M. Sklodowska-Curie Memorial Institute, Gliwice, Poland
,
Aleksandra Holowiecka-GoralHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
,
Waldemar SawickiHematology Department, Military Medical Institute, Warsaw, Poland
,
Anna EjdukHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
,
Elzbieta PatkowskaHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland;Center of Postgraduate Medical Education, Warsaw, Poland
,
Joanna MankoHematology Department, Medical University of Lublin, Lublin, Poland
,
Justyna Gajkowska-KulikHematology Department, Nicolaus Copernicus Hospital, Torun, Poland
,
Jaroslaw PiszczHematology Department, Medical University of Bialystok, Bialystok, Poland
,
Monika Mordak-DomagalaLower Silesian Centrum for Cellular Transplantation, Wroclaw, Poland
,
Krzysztof MadryHematology and Oncology Department, Warsaw Medical University, Warsaw, Poland
,
Jerzy HolowieckiDepartment of Bone Marrow Transplantation, Comprehensive Cancer Center, M. Sklodowska-Curie Memorial Institute, Gliwice, Poland
,
Slawomira Kyrcz-KrzemienHematology Department and BMT, Medical University of Silesia, Katowice, Poland
,
Maria Nowakowska-DomagalaHematology Department, Center of Oncology, Kielce, Poland
,
Anna DmoszynskaHematology Department, Medical University of Lublin, Lublin, Poland
,
Malgorzata CalbeckaHematology Department, Nicolaus Copernicus Hospital, Torun, Poland
,
Janusz KloczkoHematology Department, Medical University of Bialystok, Bialystok, Poland
,
Wiesław Wiktor JędrzejczakHematology and Oncology Department, Warsaw Medical University, Warsaw, Poland
,
Andrzej LangeLower Silesian Centrum for Cellular Transplantation, Wroclaw, Poland
,
Malgorzata RaznyHematology Department, Rydygier Memorial Hospital, Krakow, Poland
,
Przemyslaw BilinskiHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
,
Krzysztof WarzochaHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
&
Ewa Lech-MarandaHematology Department, Institute of Hematology and Transfusion Medicine, Warsaw, Poland;Center of Postgraduate Medical Education, Warsaw, PolandCorrespondence[email protected]
 show all
Pages 2331-2338 | Received 06 Nov 2013, Accepted 04 Nov 2014, Published online: 21 Jan 2015
 
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Abstract

This prospective study estimated outcomes in 509 elderly patients with acute myeloid leukemia (AML) with different treatment approaches depending on Eastern Cooperative Oncology Group (ECOG) performance status and Charlson Comorbidity Index (CCI). Patients were stratified into fit (ECOG 0–2 and CCI 0–2) or frail (ECOG > 2 and/or CCI > 2) groups. Fit patients with CCI 0 received intensive chemotherapy whilst reduced-intensive chemotherapy (R-IC) was given to those with CCI 1–2. Frail patients received best supportive therapy. Fit patients presented a longer overall survival (OS) than frail subjects, but 8-week mortality rates were similar. The complete response (CR) rate between fit CCI 0 and CCI 1–2 subgroups was significantly different. Both of the fit subgroups showed similar 8-week mortality rates and OS probabilities. Allocating fit patients with CCI 1–2 to R-IC enabled an increase in the group of elderly patients who could be treated with the intention of inducing remission.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.

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