|
|
Blood, 1 May 2006, Vol. 107, No. 9, pp. 3481-3485.
Prepublished online as a Blood First Edition Paper on February 2, 2006; DOI 10.1182/blood-2005-09-3724.
 Previous Article | Next Article 
Submitted September 15, 2005
Accepted December 24, 2005
Age and acute myeloid leukemia
Frederick R Appelbaum*, Holly M Gundacker, David R Head, Marilyn L Slovak, Cheryl L Willman, John E Godwin, Jeanne E Anderson, and Stephen H Petersdorf
Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Southwest Oncology Group Statistical Center, Seattle, WA, USA
Vanderbilt University Medical Center, Nashville, TN, USA
City of Hope National Medical Center, Duarte, CA, USA
University of New Mexico, Albuquerque, NM, USA
Loyola University Stritch School of Medicine, Maywood, IL, USA
Katmai Oncology Group, Anchorage, AK, USA
Seattle Cancer Care Alliance, Seattle, WA, USA
* Corresponding author; email: fappelba{at}fhcrc.org.
We conducted a retrospective analysis of 968 adults with AML on five recent Southwest Oncology Group trials to understand how the nature of acute myeloid leukemia (AML) changes with age.
Older study patients with AML presented with poorer performance status, lower white counts and a lower percent of marrow blasts. Multi-drug resistance was found in 33% of AMLs in patients < age 56 compared to 57% in those > 75. The percent of patients with favorable cytogenetics dropped from 17% in those < age 56 to 4% in those > 75. In contrast, the proportion of patients with unfavorable cytogenetics increased from 35% in those < age 56 to 51% in patients > 75. Particularly striking were the increases in abnormalities of chromosomes 5, 7, and 17 among the elderly. The increased incidence of unfavorable cytogenetics contributed to their poorer outcome and within each cytogenetic risk group, treatment outcome deteriorated markedly with age. Finally, the combination of a poor performance status and advanced age identified a group of patients with a very high likelihood of dying within 30 days of initiating induction therapy. The distinct biology and clinical responses seen argue for age-specific assessments when evaluating therapies for AML.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
A. V. Rao, P. J.M. Valk, K. H. Metzeler, C. R. Acharya, S. A. Tuchman, M. M. Stevenson, D. A. Rizzieri, R. Delwel, C. Buske, S. K. Bohlander, et al.
Age-Specific Differences in Oncogenic Pathway Dysregulation and Anthracycline Sensitivity in Patients With Acute Myeloid Leukemia
J. Clin. Oncol.,
November 20, 2009;
27(33):
5580 - 5586.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Bauer, N. Skoetz, C. Brillant, C. Herbst, I. Monsef, S. Kluge, and A. Engert
Tenth Biannual Report of the Cochrane Haematological Malignancies Group--Focus on Acute Myeloid Leukemia
J Natl Cancer Inst,
October 21, 2009;
101(20):
E1 - E1.
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. J. M. de Jonge, E. S. J. M. de Bont, P. J. M. Valk, J. J. Schuringa, M. Kies, C. M. Woolthuis, R. Delwel, N. J. G. M. Veeger, E. Vellenga, B. Lowenberg, et al.
AML at older age: age-related gene expression profiles reveal a paradoxical down-regulation of p16INK4A mRNA with prognostic significance
Blood,
October 1, 2009;
114(14):
2869 - 2877.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Lowenberg, G. J. Ossenkoppele, W. van Putten, H. C. Schouten, C. Graux, A. Ferrant, P. Sonneveld, J. Maertens, M. Jongen-Lavrencic, M. von Lilienfeld-Toal, et al.
High-Dose Daunorubicin in Older Patients with Acute Myeloid Leukemia
N. Engl. J. Med.,
September 24, 2009;
361(13):
1235 - 1248.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. R. Dey, T. R. Spitzer, and R. P. Hasserjian
Case 28-2009 -- A 68-Year-Old Man with Fatigue, Cough, and Peripheral-Blood Monocytosis
N. Engl. J. Med.,
September 10, 2009;
361(11):
1099 - 1106.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-L. Harousseau, G. Martinelli, W. W. Jedrzejczak, J. M. Brandwein, D. Bordessoule, T. Masszi, G. J. Ossenkoppele, J. A. Alexeeva, G. Beutel, J. Maertens, et al.
A randomized phase 3 study of tipifarnib compared with best supportive care, including hydroxyurea, in the treatment of newly diagnosed acute myeloid leukemia in patients 70 years or older
Blood,
August 6, 2009;
114(6):
1166 - 1173.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Karp, K. Flatten, E. J. Feldman, J. M. Greer, D. A. Loegering, R. M. Ricklis, L. E. Morris, E. Ritchie, B. D. Smith, V. Ironside, et al.
Active oral regimen for elderly adults with newly diagnosed acute myelogenous leukemia: a preclinical and phase 1 trial of the farnesyltransferase inhibitor tipifarnib (R115777, Zarnestra) combined with etoposide
Blood,
May 14, 2009;
113(20):
4841 - 4852.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Juliusson, P. Antunovic, A. Derolf, S. Lehmann, L. Mollgard, D. Stockelberg, U. Tidefelt, A. Wahlin, and M. Hoglund
Age and acute myeloid leukemia: real world data on decision to treat and outcomes from the Swedish Acute Leukemia Registry
Blood,
April 30, 2009;
113(18):
4179 - 4187.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. D. Klepin and L. Balducci
Acute Myelogenous Leukemia in Older Adults
Oncologist,
March 1, 2009;
14(3):
222 - 232.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. S. Becker, K. J. Kopecky, A. N. Wilks, S. Chien, J. M. Harlan, C. L. Willman, S. H. Petersdorf, D. L. Stirewalt, T. Papayannopoulou, and F. R. Appelbaum
Very late antigen-4 function of myeloblasts correlates with improved overall survival for patients with acute myeloid leukemia
Blood,
January 22, 2009;
113(4):
866 - 874.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Buchner, W. E. Berdel, C. Haferlach, T. Haferlach, S. Schnittger, C. Muller-Tidow, J. Braess, K. Spiekermann, J. Kienast, P. Staib, et al.
Age-Related Risk Profile and Chemotherapy Dose Response in Acute Myeloid Leukemia: A Study by the German Acute Myeloid Leukemia Cooperative Group
J. Clin. Oncol.,
January 1, 2009;
27(1):
61 - 69.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. D. Shah and J. E. Lancet
Frontline Treatment of Acute Myeloid Leukemia: Are We Making Progress?
ASCO Educational Book,
January 1, 2009;
2009(1):
372 - 377.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. J. Roboz
Treatment of Elderly Patients with Acute Myeloid Leukemia: Lowering the Intensity
ASCO Educational Book,
January 1, 2009;
2009(1):
378 - 383.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Sekeres, P. Elson, M. E. Kalaycio, A. S. Advani, E. A. Copelan, S. Faderl, H. M. Kantarjian, and E. Estey
Time from diagnosis to treatment initiation predicts survival in younger, but not older, acute myeloid leukemia patients
Blood,
January 1, 2009;
113(1):
28 - 36.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-V. Malfuson, A. Etienne, P. Turlure, T. de Revel, X. Thomas, N. Contentin, C. Terre, S. Rigaudeau, D. Bordessoule, N. Vey, et al.
Risk factors and decision criteria for intensive chemotherapy in older patients with acute myeloid leukemia
Haematologica,
December 1, 2008;
93(12):
1806 - 1813.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Schetelig, M. Bornhauser, C. Schmid, B. Hertenstein, R. Schwerdtfeger, H. Martin, M. Stelljes, U. Hegenbart, K. Schafer-Eckart, M. Fussel, et al.
Matched Unrelated or Matched Sibling Donors Result in Comparable Survival After Allogeneic Stem-Cell Transplantation in Elderly Patients With Acute Myeloid Leukemia: A Report From the Cooperative German Transplant Study Group
J. Clin. Oncol.,
November 10, 2008;
26(32):
5183 - 5191.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Laubach and A. V. Rao
Current and Emerging Strategies for the Management of Acute Myeloid Leukemia in the Elderly
Oncologist,
October 1, 2008;
13(10):
1097 - 1108.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Faderl, F. Ravandi, X. Huang, G. Garcia-Manero, A. Ferrajoli, Z. Estrov, G. Borthakur, S. Verstovsek, D. A. Thomas, M. Kwari, et al.
A randomized study of clofarabine versus clofarabine plus low-dose cytarabine as front-line therapy for patients aged 60 years and older with acute myeloid leukemia and high-risk myelodysplastic syndrome
Blood,
September 1, 2008;
112(5):
1638 - 1645.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Wandt, U. Schakel, F. Kroschinsky, G. Prange-Krex, B. Mohr, C. Thiede, U. Pascheberg, S. Soucek, M. Schaich, and G. Ehninger
MLD according to the WHO classification in AML has no correlation with age and no independent prognostic relevance as analyzed in 1766 patients
Blood,
February 15, 2008;
111(4):
1855 - 1861.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Baer, H. D. Klepin, and A. S. Artz
Acute Leukemia in Older Adults: Are We Treating Too Much or Too Little?
ASCO Educational Book,
January 1, 2008;
2008(1):
216 - 223.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Sorror, S. Giralt, B. M. Sandmaier, M. De Lima, M. Shahjahan, D. G. Maloney, H. J. Deeg, F. R. Appelbaum, B. Storer, and R. Storb
Hematopoietic cell transplantation specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences
Blood,
December 15, 2007;
110(13):
4606 - 4613.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. Sorror, B. M. Sandmaier, B. E. Storer, M. B. Maris, F. Baron, D. G. Maloney, B. L. Scott, H. J. Deeg, F. R. Appelbaum, and R. Storb
Comorbidity and Disease Status Based Risk Stratification of Outcomes Among Patients With Acute Myeloid Leukemia or Myelodysplasia Receiving Allogeneic Hematopoietic Cell Transplantation
J. Clin. Oncol.,
September 20, 2007;
25(27):
4246 - 4254.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Gardin, P. Turlure, T. Fagot, X. Thomas, C. Terre, N. Contentin, E. Raffoux, S. de Botton, C. Pautas, O. Reman, et al.
Postremission treatment of elderly patients with acute myeloid leukemia in first complete remission after intensive induction chemotherapy:results of the multicenter randomized Acute Leukemia French Association (ALFA) 9803 trial
Blood,
June 15, 2007;
109(12):
5129 - 5135.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Estey
Acute Myeloid Leukemia and Myelodysplastic Syndromes in Older Patients
J. Clin. Oncol.,
May 10, 2007;
25(14):
1908 - 1915.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Gojo, A. Jiemjit, J. B. Trepel, A. Sparreboom, W. D. Figg, S. Rollins, M. L. Tidwell, J. Greer, E. J. Chung, M.-J. Lee, et al.
Phase 1 and pharmacologic study of MS-275, a histone deacetylase inhibitor, in adults with refractory and relapsed acute leukemias
Blood,
April 1, 2007;
109(7):
2781 - 2790.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. R. Appelbaum, D. Rosenblum, R. J. Arceci, W. L. Carroll, P. P. Breitfeld, S. J. Forman, R. A. Larson, S. J. Lee, S. B. Murphy, S. O'Brien, et al.
End points to establish the efficacy of new agents in the treatment of acute leukemia
Blood,
March 1, 2007;
109(5):
1810 - 1816.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. E. Lancet, I. Gojo, J. Gotlib, E. J. Feldman, J. Greer, J. L. Liesveld, L. M. Bruzek, L. Morris, Y. Park, A. A. Adjei, et al.
A phase 2 study of the farnesyltransferase inhibitor tipifarnib in poor-risk and elderly patients with previously untreated acute myelogenous leukemia
Blood,
February 15, 2007;
109(4):
1387 - 1394.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. P. Erba
Prognostic Factors in Elderly Patients with AML and the Implications for Treatment
Hematology,
January 1, 2007;
2007(1):
420 - 428.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Jeha and F. J. Giles
Acute myeloid leukemia
ASH Self-Assessment Program,
January 1, 2007;
2007(1):
243 - 252.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Buchner, W. E. Berdel, C. Schoch, T. Haferlach, H. L. Serve, J. Kienast, S. Schnittger, W. Kern, J. Tchinda, A. Reichle, et al.
Changes in the Hierarchy of Risk Factors with Older Age in De-Novo Acute Myeloid Leukemia (AML).
Blood (ASH Annual Meeting Abstracts),
November 16, 2006;
108(11):
1977 - 1977.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. S. Dhami, A. Bulgaru, K. Jagathambal, D. Kapur, D. E. Slater, E. G. Maderazo, and F. A. Bauer
Treatment of Acute Myeloid Leukemia in a Community Hospital.
Blood (ASH Annual Meeting Abstracts),
November 16, 2006;
108(11):
4575 - 4575.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. M. Stone
Older AML patients: fit for what?
Blood,
November 15, 2006;
108(10):
3232 - 3233.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Schiffer
Clinical Issues in the Management of Patients with Myelodysplasia
Hematology,
January 1, 2006;
2006(1):
205 - 210.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
