Age and remission induction therapy for acute myeloid leukemia: An analysis of data from the Korean acute myeloid leukemia registry

PLoS One. 2021 May 7;16(5):e0251011. doi: 10.1371/journal.pone.0251011. eCollection 2021.

Abstract

Objective: The clinical characteristics and therapeutic strategy in acute myeloid leukemia (AML) are influenced by patients' age. We evaluated the impact of age on remission induction therapy for AML.

Methods: We retrospectively analyzed 3,011 adult AML patients identified from a nationwide database between January 2007 and December 2011.

Results: Three hundred twenty-nine (10.9%) acute promyelocytic leukemia (APL) and 2,682 (89.1%) non-APL patients were analyzed. The median age was 51 years and 55% of patients were male. Six hundred twenty-three patients (21%) were at favorable risk, 1522 (51%) were at intermediate risk, and 743 (25%) were at poor risk. As the age increased, the proportion of those at favorable risk and who received induction chemotherapy decreased. After induction therapy, complete response (CR) was achieved in 81.5% (243/298) of APL and 62.4% (1,409/2,258) of non-APL patients; these rates decreased as the age increased, with an obvious decrement in those older than 60 years. The median overall survival of non-APL patients was 18.7 months, while that of APL patients was not reached, with a 75% five-year survival rate.

Conclusions: Age impacts both the biology and clinical outcomes of AML patients. Further studies should confirm the role of induction remission chemotherapy by age group.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Female
  • Humans
  • Induction Chemotherapy*
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / mortality
  • Male
  • Middle Aged
  • Registries
  • Remission Induction
  • Republic of Korea
  • Retrospective Studies
  • Survival Rate
  • Young Adult

Grants and funding

HK was supported by the Gachon University research fund of 2017 (GCU-2017-5257). This study was also supported by The Korean Society of Hematology AML/MDS Working Party (AMLMDSWP-15-R-02). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Gachon University (https://www.gachon.ac.kr) Korean Society of Hematology AML/MDS Working Party (https://www.hematology.or.kr/research_member/main.html?comm_code=com_01).