Chemotherapy improves survival in acute myeloid leukemia patients 75 years or older to an extent similar to that seen in younger patients, according to a report in the medical journal Cancer.
Elderly patients are often excluded from aggressive treatment because of the prevailing opinion that they have a low chance of sustaining a durable remission and a high risk of dying from the toxic effects of treatment, the authors point out.
To investigate, Dr. Norbert Vey from Institut Paoli-Calmettes, Marseille, France and colleagues compared the results of intensive chemotherapy with the outcome of suboptimal chemotherapy in 310 elderly patients. Of these, 110 were 75 years or older.
Although there were no differences between the treatment groups in disease characteristics, patients in the older group were less likely to receive intensive chemotherapy than were younger patients (between 65-74 years), the authors report.
Complete remission rates approached 50 percent in both age groups, and the major cause of treatment failure was leukemia resistance to drug therapy.
Two-year overall survival rates were significantly higher in the 65-74 year old group (23 percent) than in the older group (19 percent), the researchers note, but survival rates did not differ significantly when the analysis was restricted to patients who received intensive therapy.
In further analyses, the only factor found to have a significant impact on survival was the type of therapy. In a logistic regression analysis, however, increasing age contributed to the overall risk of death.
These results “do not support the systematic exclusion of patients age 75 years and older from intensive treatment,” the authors conclude.
SOURCE: Cancer June 7, 2004.
Revision date: July 7, 2011
Last revised: by Jorge P. Ribeiro, MD