The prognostic factors and efficacy of induction chemotherapy in elderly patients with acute myeloid leukemia.

Background And Objective: Acute myeloid leukemia (AML) is the most common form of hematological malignancy in adults. We aimed to investigate the efficacy of different treatment measures and prognostic factors for elderly patients with AML.

Methods: The clinical data of 65 newly diagnosed elderly patients with AML were retrospectively analyzed. Among them, 45 patients received induction chemotherapy including standard cytarabine regimen (n = 21) and low dose cytarabine regimen (n = 24), and 20 patients received palliative treatment. The efficacy and prognosis were compared between the groups.

Results: There were no statistical differences in complete remission, overall survival and the 6-month disease-free survival rates between standard cytarabine group and low dose cytarabine group ( = 0.675, = 0.775, = 0.751, respectively). Significant difference in median overall survival and overall survival rate were detected ( < 0.001, = 0.031, respectively), but no significant difference in early death rate ( = 0.238) was found between induction chemotherapy group and palliative treatment group. Multivariate analysis showed that the white blood cells count ≥ 100.0 × 10/L was associated with early death.

Conclusions: The induction chemotherapy did not increase the early mortality. The low dose cytarabine regimen can be used as the first-line choice for elderly acute myeloid leukemia patients who are not suitable for intensive chemotherapy.