Document Detail


Intensive chemotherapy is not recommended for patients aged >60 years who have myelodysplastic syndromes or acute myeloid leukemia with high-risk karyotypes.
MedLine Citation:
PMID:  17559141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is unclear whether intensive chemotherapy is beneficial to patients with high-risk myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) if they are aged >/=60 years. METHODS: The authors studied 160 patients with a median age of 67 years who received intensive chemotherapy for MDS or AML with cytosine arabinoside and an anthracycline. RESULTS: At diagnosis, cytogenetic analysis was available in 146 patients. Karyotype was normal in 78 patients and abnormal in 68 patients. Of the abnormal karyotypes, 32 belonged to the high-risk category, ie, they involved either >/=3 chromosomes or chromosome 7. Complete remission (CR) was achieved by 94 patients (56%). CR rates were 70% among the patients who had a normal karyotype, 69% among the patients who had an abnormal (noncomplex) karyotype, but only 46% among the patients ho had a high-risk karyotype. The median survival was 9.5 months in the entire group, 18 months in patients with normal karyotype, 6 months in patients with abnormal, and 4 months in patients with a high-risk karyotype. A poor prognosis was attributable to low rates of CR and a high risk of early recurrence. CONCLUSIONS: According to the current data, elderly patients with AML or advanced MDS do not benefit from intensive chemotherapy if they show karyotype anomalies, especially those in the high-risk category.
Authors:
Sabine Knipp; Barbara Hildebrand; Andrea Kündgen; Aristoteles Giagounidis; Guido Kobbe; Rainer Haas; Carlo Aul; Norbert Gattermann; Ulrich Germing
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer     Volume:  110     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-09     Completed Date:  2007-09-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  345-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine University, Dusseldorf, Germany. sabineknipp@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Female
Humans
Karyotyping
Leukemia, Myeloid / drug therapy*,  genetics*
Male
Middle Aged
Myelodysplastic Syndromes / drug therapy*,  genetics*
Remission Induction
Survival Analysis
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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