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.
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: Michael Lübbert; Björn H Rüter; Rainer Claus; Claudia Schmoor; Mathias Schmid; Ulrich Germing; Andrea Kuendgen; Volker Rethwisch; Arnold Ganser; Uwe Platzbecker; Oliver Galm; Wolfram Brugger; Gerhard Heil; Björn Hackanson; Barbara Deschler; Konstanze Döhner; Anne Hagemeijer; Pierre W Wijermans; Hartmut Döhner Journal: Haematologica Date: 2011-11-04 Impact factor: 9.941
Authors: Pierre Fenaux; Ghulam J Mufti; Eva Hellstrom-Lindberg; Valeria Santini; Carlo Finelli; Aristoteles Giagounidis; Robert Schoch; Norbert Gattermann; Guillermo Sanz; Alan List; Steven D Gore; John F Seymour; John M Bennett; John Byrd; Jay Backstrom; Linda Zimmerman; David McKenzie; Cl Beach; Lewis R Silverman Journal: Lancet Oncol Date: 2009-02-21 Impact factor: 41.316
Authors: Reinhard Stauder; Friedrich Wimazal; Thomas Nösslinger; Otto Krieger; Wolfgang R Sperr; Heinz Sill; Michael Pfeilstöcker; Peter Valent Journal: Wien Klin Wochenschr Date: 2008 Impact factor: 1.704
Authors: Bernard Tawfik; Sarunas Sliesoraitis; Susan Lyerly; Heidi D Klepin; Julia Lawrence; Scott Isom; Leslie R Ellis; Megan Manuel; Sarah Dralle; Dmitriy Berenzon; Bayard L Powell; Timothy Pardee Journal: Ann Hematol Date: 2013-10-23 Impact factor: 3.673