Elderly Acute Myeloid Leukemia: A Retrospective Analysis of 89 Cases in China.

Although acute myeloid leukemia (AML) is generally responsive to chemotherapy, most patients with this disease are older than 60 years and have relatively resistant neoplasms. AML in the older patient is distinctive, both biologically and clinically, from that occurring in patients younger than 60. The intrinsic resistance of AML in the older patient is exemplified by the higher incidence of chromosomal abnormalities. Furthermore, blasts obtained in elderly patients with AML are more likely to express proteins that mediate multidrug resistance, such as the p-glycoprotein encoded by the MDR1 gene. A combination of an anthracycline and a cytarabine is the most commonly used induction regimen in acute myeloid leukemia (AML), but most of Chinese older adults with AML didn’t agree with the standard doses of induction therapy. The study is to analysis the attenuated therapy for Chinese older adults. 89cases of newly diagnosed aged over 60 were observed from February 2000 to July 2005, including 50 male and 39 female, media age is 68yr. Patients were accepted attenuated therapy, either mitoxantrone per day on days 1, 2(MA);35 mg/m2 pirarubicin(TA) 7–8mg/m2 idarubicin per day on days 1, 2 (IA). Each patient was given 100mg/m2 cytarabine intravenously per day for 7 days. Total CR rate was 34% after 2 regimens, 2 years survival rate was 12.5%. The CR and 2-year survival rates of acute leukemia in Chinese elderly AML were low. Physicians should be encouraged to offer standard doses of induction therapy.