Summary of important features of AML in elderly (APL excluded)
| AML in the elderly . |
|---|
| Epidemiology |
| The median age of adult AML patients is 72 y, and the mean age is 68 y; similar for males and females. |
| AML has a peak incidence at 80-84 y. |
| Males over 70 years have a higher incidence than females of the same age. |
| At least 70% of patients up to age 80 have a performance status of 0-II. |
| One-fourth of the AML patients have a previous hematological disease. |
| The proportion of secondary AML is largest in ages 70-74, when one-third have a previous hematological disease. |
| Clinical |
| Most patients up to age 80 benefit from standard intensive treatment. |
| Standard intensive treatment decreases rather than increases early death rate. |
| Complete remission is achieved with intensive treatment in at least half of the patients up to age 75, and in patients with good performance status up to age 80. |
| Complete remission is less frequently achieved in secondary AML as compared to de novo AML, but early death rates are similar. |
| Performance status is more predictive for early death rate than age. |
| Long-term survival may be achieved also in patients with initial poor performance status. |
| Selection criteria commonly used for inclusion into clinical studies have a major impact on reported outcome. |
| From previous studies |
| Patients in remission from AML require less supportive care and hospitalization and have a better quality of life than patients during palliation. |
| Interpretation |
| Remission, even if of short duration, is a reasonable aim also in elderly patients with AML. |
| Most patients up to age 80 should be considered for standard intensive treatment. |
| New treatments should be compared to standard intensive treatment, also in elderly. |
| AML in the elderly . |
|---|
| Epidemiology |
| The median age of adult AML patients is 72 y, and the mean age is 68 y; similar for males and females. |
| AML has a peak incidence at 80-84 y. |
| Males over 70 years have a higher incidence than females of the same age. |
| At least 70% of patients up to age 80 have a performance status of 0-II. |
| One-fourth of the AML patients have a previous hematological disease. |
| The proportion of secondary AML is largest in ages 70-74, when one-third have a previous hematological disease. |
| Clinical |
| Most patients up to age 80 benefit from standard intensive treatment. |
| Standard intensive treatment decreases rather than increases early death rate. |
| Complete remission is achieved with intensive treatment in at least half of the patients up to age 75, and in patients with good performance status up to age 80. |
| Complete remission is less frequently achieved in secondary AML as compared to de novo AML, but early death rates are similar. |
| Performance status is more predictive for early death rate than age. |
| Long-term survival may be achieved also in patients with initial poor performance status. |
| Selection criteria commonly used for inclusion into clinical studies have a major impact on reported outcome. |
| From previous studies |
| Patients in remission from AML require less supportive care and hospitalization and have a better quality of life than patients during palliation. |
| Interpretation |
| Remission, even if of short duration, is a reasonable aim also in elderly patients with AML. |
| Most patients up to age 80 should be considered for standard intensive treatment. |
| New treatments should be compared to standard intensive treatment, also in elderly. |