Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital
OBJECTIVE: To evaluate the outcomes of acute myeloid leukemia patients who were older than 60 years of age at the time of diagnosis following the implementation of a treatment algorithm based on age, performance status, and cytogenetic results. METHODS: We retrospectively compared the results of 31 elderly acute myeloid leukemia patients (median age of 74 years) who were treated according to the new algorithm. RESULTS: Fifteen patients with a good performance status and no unfavorable karyotypes were treated with either intensive cytotoxic chemotherapy (<70 years, nine cases) or adapted etoposide, 6-thioguanine and idarubicine (>70 years, six cases); 16 cases with a poor performance status or unfavorable cytogenetics received supportive care only. Six patients achieved a complete remission and two achieved a partial remission after chemotherapy. There were three toxic deaths during induction, two in the adapted etoposide, 6-thioguanine and idarubicine group and one in the intensive cytotoxic chemotherapy group. The overall median survival time was 2.96 months, 1.3 months in the supportive care group, and 4.6 months in the treatment group. CONCLUSIONS: Our results illustrate the importance of treatment guidelines adapted to local resources in an attempt to improve the survival of elderly acute myeloid leukemia patients in developing countries.
Main Authors: | , , , , |
---|---|
Format: | Digital revista |
Language: | English |
Published: |
Faculdade de Medicina / USP
2011
|
Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000800005 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
oai:scielo:S1807-59322011000800005 |
---|---|
record_format |
ojs |
spelling |
oai:scielo:S1807-593220110008000052011-08-30Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University HospitalSandes,Alex FreireRibeiro,Juliana Correa da CostaBarroso,Rodrigo S.Silva,Maria R.R.Chauffaille,Maria L.L.F. Acute Myeloid Leukemia Elderly Intensive Chemotherapy Adapted ETI Prognosis OBJECTIVE: To evaluate the outcomes of acute myeloid leukemia patients who were older than 60 years of age at the time of diagnosis following the implementation of a treatment algorithm based on age, performance status, and cytogenetic results. METHODS: We retrospectively compared the results of 31 elderly acute myeloid leukemia patients (median age of 74 years) who were treated according to the new algorithm. RESULTS: Fifteen patients with a good performance status and no unfavorable karyotypes were treated with either intensive cytotoxic chemotherapy (<70 years, nine cases) or adapted etoposide, 6-thioguanine and idarubicine (>70 years, six cases); 16 cases with a poor performance status or unfavorable cytogenetics received supportive care only. Six patients achieved a complete remission and two achieved a partial remission after chemotherapy. There were three toxic deaths during induction, two in the adapted etoposide, 6-thioguanine and idarubicine group and one in the intensive cytotoxic chemotherapy group. The overall median survival time was 2.96 months, 1.3 months in the supportive care group, and 4.6 months in the treatment group. CONCLUSIONS: Our results illustrate the importance of treatment guidelines adapted to local resources in an attempt to improve the survival of elderly acute myeloid leukemia patients in developing countries.info:eu-repo/semantics/openAccessFaculdade de Medicina / USPClinics v.66 n.8 20112011-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000800005en10.1590/S1807-59322011000800005 |
institution |
SCIELO |
collection |
OJS |
country |
Brasil |
countrycode |
BR |
component |
Revista |
access |
En linea |
databasecode |
rev-scielo-br |
tag |
revista |
region |
America del Sur |
libraryname |
SciELO |
language |
English |
format |
Digital |
author |
Sandes,Alex Freire Ribeiro,Juliana Correa da Costa Barroso,Rodrigo S. Silva,Maria R.R. Chauffaille,Maria L.L.F. |
spellingShingle |
Sandes,Alex Freire Ribeiro,Juliana Correa da Costa Barroso,Rodrigo S. Silva,Maria R.R. Chauffaille,Maria L.L.F. Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
author_facet |
Sandes,Alex Freire Ribeiro,Juliana Correa da Costa Barroso,Rodrigo S. Silva,Maria R.R. Chauffaille,Maria L.L.F. |
author_sort |
Sandes,Alex Freire |
title |
Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
title_short |
Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
title_full |
Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
title_fullStr |
Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
title_full_unstemmed |
Improving the outcomes of elderly patients with acute myeloid leukemia in a Brazilian University Hospital |
title_sort |
improving the outcomes of elderly patients with acute myeloid leukemia in a brazilian university hospital |
description |
OBJECTIVE: To evaluate the outcomes of acute myeloid leukemia patients who were older than 60 years of age at the time of diagnosis following the implementation of a treatment algorithm based on age, performance status, and cytogenetic results. METHODS: We retrospectively compared the results of 31 elderly acute myeloid leukemia patients (median age of 74 years) who were treated according to the new algorithm. RESULTS: Fifteen patients with a good performance status and no unfavorable karyotypes were treated with either intensive cytotoxic chemotherapy (<70 years, nine cases) or adapted etoposide, 6-thioguanine and idarubicine (>70 years, six cases); 16 cases with a poor performance status or unfavorable cytogenetics received supportive care only. Six patients achieved a complete remission and two achieved a partial remission after chemotherapy. There were three toxic deaths during induction, two in the adapted etoposide, 6-thioguanine and idarubicine group and one in the intensive cytotoxic chemotherapy group. The overall median survival time was 2.96 months, 1.3 months in the supportive care group, and 4.6 months in the treatment group. CONCLUSIONS: Our results illustrate the importance of treatment guidelines adapted to local resources in an attempt to improve the survival of elderly acute myeloid leukemia patients in developing countries. |
publisher |
Faculdade de Medicina / USP |
publishDate |
2011 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322011000800005 |
work_keys_str_mv |
AT sandesalexfreire improvingtheoutcomesofelderlypatientswithacutemyeloidleukemiainabrazilianuniversityhospital AT ribeirojulianacorreadacosta improvingtheoutcomesofelderlypatientswithacutemyeloidleukemiainabrazilianuniversityhospital AT barrosorodrigos improvingtheoutcomesofelderlypatientswithacutemyeloidleukemiainabrazilianuniversityhospital AT silvamariarr improvingtheoutcomesofelderlypatientswithacutemyeloidleukemiainabrazilianuniversityhospital AT chauffaillemariallf improvingtheoutcomesofelderlypatientswithacutemyeloidleukemiainabrazilianuniversityhospital |
_version_ |
1756432126666866688 |