ACUTE MYELOGENOUS LEUKEMIA AND AGING

作者：Jeffrey E. Lancet, Cheryl L. Willman, John M. Bennett · 发表于：Hematology/Oncology Clinics of North America · 年份：2000 · DOI：10.1016/s0889-8588(05)70287-2 · 被引用次数：74 · 研究领域：Acute Myeloid Leukemia Research、Acute Lymphoblastic Leukemia research、Retinoids in leukemia and cellular processes

Acute myelogenous leukemia (AML) is a devastating disease that afflicts the elderly more frequently than the young. Ironically, many of the recent therapeutic advances are not deemed suitable for the very population of patients that suffers most from this illness. This point raises competing issues. On one hand, the effect of modern therapy for AML in the elderly may be skewed by the underrepresentation of the elderly in clinical trials. Indeed, Ferrara showed that only 55% of patients over the age of 60 years were enrolled in clinical trials, as compared with more than 90% of younger patients.12 In leukemia, specifically, less than 10% of clinical trial participants were older than 65 years, even though this cohort represents more than 55% of patients with leukemia.65 On the other hand, elderly patients enrolled in prospective randomized studies may not be representative of the total elderly AML population but may instead represent a cohort of healthier patients. A prospective British study of AML in the elderly found that only 89 of 200 patients newly diagnosed with AML were considered fit enough to receive treatment with curative intent. This finding emphasizes that the elderly are frequently afflicted with comorbidities that preclude aggressive therapy.59 The definition of elderly is difficult to determine, because it involves biologic considerations and chronologic age. Most therapeutic trials in the United States include patients aged 55 years or older in this category....