Treatment of newly-diagnosed acute myelogenous leukaemia in patients aged 80 years and above

In order to assess outcome following treatment of acute myeloid leukaemia (AML) in patients aged 80 years and above, we have studied 33 patients aged greater than or equal to 80 years treated between 1980 and 1994; 29 of these received treatment. The median age was 82 years (range 80-89). Three patients received daunorubicin (greater than or equal to 60 mg/m(2) daily x 3) alone or with low-dose ara-C, two patients received '3 + 7' with post-treatment GM-CSF; 24 patients had higher doses of ara-C, generally with anthracyclines or fludarabine, and in nine cases with G or GM-CSF. The median survival of the treated patients was 3-4 weeks and only two were alive after 1 year (at 66 and 79 weeks). Complete remission (CR) occurred in 9/29 (31%). Only one of the nine remains alive in remission, at 76 weeks after the date of CR, whereas the other eight died in remission or had disease recurrence at a median of 11 weeks (range 5-37 weeks) after CR. The median survival of the four untreated patients was 10 weeks (range 3-38). Patients aged greater than or equal to 80 had, on average, worse outcomes than those observed in patients aged 70-79. Our results confirm that currently available chemotherapy is generally not indicated in patients aged 80 or over with AML.