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Prognostic Index for Older Adult Patients with Newly Diagnosed Acute Myeloid Leukemia: The Edouard Herriot Hospital Experience
- Source :
- Clinical Leukemia. 2:198-204
- Publication Year :
- 2008
- Publisher :
- Elsevier BV, 2008.
-
Abstract
- Background The treatment of elderly adults with acute myeloid leukemia (AML) is associated with unsatisfactory rates of complete responses and long-term overall survival (OS). Therefore, a clinically useful prognostic index would facilitate therapeutic decision-making and evaluation of investigational treatment strategies in this patient population. Patients and Methods A prognostic score is presented based on the multivariate analysis of 432 patients with non-M3 AML aged > 60 years, selected on the basis of their initial performance status and the absence of severe comorbid factors for entering into 5 successive clinical trials combining an anthracycline and cytarabine. Four clinically relevant parameters are included in this index: cytogenetics at diagnosis, history of previous hematologic disorder, hematologic features at diagnosis, and lactate dehydrogenase level at diagnosis. Results Using this stratification system, 3 risk groups were defined: a favorable-risk group A (OS of 39% at 2 years and 21% at 5 years), an intermediate-risk group B (OS of 19% at 2 years and 8% at 5 years), and a poor-risk group C (OS of 5% at 2 years and 0 at 5 years). Conclusion The prognostic index estimates the outcome of elderly patients with AML usually selected for intensive chemotherapy trials using 4 easily determined parameters and might identify patients who are really candidates for this treatment strategy from those for whom investigational therapy or palliation might be most appropriate.
Details
- ISSN :
- 19316925
- Volume :
- 2
- Database :
- OpenAIRE
- Journal :
- Clinical Leukemia
- Accession number :
- edsair.doi...........3806da54451597d31630c13188ce3868
- Full Text :
- https://doi.org/10.3816/clk.2008.n.025