Acute myeloid leukemia in the elderly: therapeutic options and choice

Leuk Lymphoma. 2018 Feb;59(2):274-287. doi: 10.1080/10428194.2017.1330956. Epub 2017 Jun 2.

Abstract

Acute myeloid leukemia (AML) therapies are rapidly evolving with novel targeted therapies showing high-level responses in a notoriously difficult to treat group of patients - the elderly and unfit. This review will examine the outcomes of older AML patients (>60 years old) with conventional induction strategies, and published literature on risks of pursuit of induction. Low-intensity combination therapy response rates appear to be approaching that of induction regimens, and with lower toxicity, low-intensity therapy likely represents the future standard approach in this age group. Lastly, allogeneic transplant appears to have a role in increasing durable remissions regardless of age and should be considered in patients with limited comorbidities.

Keywords: AML; elderly; therapy.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Clinical Decision-Making
  • Combined Modality Therapy
  • Consolidation Chemotherapy
  • Disease Management
  • Humans
  • Incidence
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / epidemiology
  • Leukemia, Myeloid, Acute / therapy*
  • Maintenance Chemotherapy
  • Molecular Targeted Therapy
  • Mortality
  • Remission Induction / methods
  • Treatment Outcome