Management of Acute Myeloid Leukemia (AML) in Older Patients

被引：30

作者：

Abdallah, Maya ^{[1
,2
]}

Xie, Zhuoer ^{[3
]}

Ready, Audrey ^{[4
]}

Manogna, Dharmini ^{[5
]}

Mendler, Jason H. ^{[6
]}

Loh, Kah Poh ^{[6
]}

机构：

[1] Boston Univ, Sch Med, Dept Med, Hematol Oncol Sect, Boston, MA 02118 USA

[2] Boston Univ, Sch Med, Dept Med, Sect Geriatr, Boston, MA 02118 USA

[3] Mayo Clin, Dept Hematol, Rochester, MN USA

[4] Univ Massachusetts, Baystate Med Ctr, Dept Med, Springfield, MA USA

[5] Rochester Gen Hosp, Dept Med, Rochester, NY 14621 USA

[6] Univ Rochester, Med Ctr, Div Hematol Oncol, James P Wilmot Canc Ctr, 601 Elmwood Ave,Box 704, Rochester, NY 14642 USA

来源：

CURRENT ONCOLOGY REPORTS | 2020年 / 22卷 / 10期

关键词：

Acute myeloid leukemia; Treatment; Older adults; Geriatric hematology; RANDOMIZED PHASE-III; RISK MYELODYSPLASTIC SYNDROME; CONVENTIONAL CARE REGIMENS; LOW-DOSE CYTARABINE; GERIATRIC ASSESSMENT; GEMTUZUMAB OZOGAMICIN; INDUCTION CHEMOTHERAPY; SUPPORTIVE CARE; PROGNOSTIC-SIGNIFICANCE; INTENSIVE CHEMOTHERAPY;

D O I：

10.1007/s11912-020-00964-1

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose of Review The acute myeloid leukemia (AML) treatment landscape has rapidly evolved over the past few years. These changes have several implications for the care of older adults (>= 60 years), who have inferior clinical outcomes. We review decision-making in older adults, focusing on patient- and disease-related factors. We then summarize current treatment options, including multiple recently approved therapies, based on hypothetical clinical scenarios. Recent Findings In lieu of using chronological age to determine fitness, we highlight the importance of standardized fitness assessments using geriatric assessments. Next, we review intensive and lower-intensity treatment options in the upfront setting. We focus on multiple newly approved medications, including venetoclax, midostaurin, CPX-351, gemtuzumab, glasdegib, enasidenib, and ivosidenib, and their specific indications. Lastly, we briefly discuss supportive care of older adults with AML. Outcomes of older adults with AML remain poor; fortunately, there are many new promising treatment options. Personalized treatment plans based on patient- and disease-specific factors are essential to the care of older adults with AML.

引用

页数：14

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