Acute myeloid leukemia in the elderly: a review

The diagnosis and management of acute myeloid leukemia (AML) in the elderly is reviewed including the basic aspects of epidemiology, cytogenetics, and prognostic factors. AML at higher ages is associated with several unique biologic and clinical characteristics. It generally arise from an early level of hematopoietic stem cells, and has a particularly high incidence of poor prognostic karyotypes. Effective treatment of the elderly patient with AML remains a challenging task. The importance of therapeutic approaches and promising new drugs is summarized. Prospective randomized studies clearly demonstrate that elderly patients benefit from intensive induction therapy Hematopoietic growth factors accelerate the recovery from treatment-induced neutropenia and may improve the outcome. In patients not eligible for intensive chemotherapy, prospective studies testing different palliative or moderately intensive treatments are needed to improve quality of life and survival New treatment strategies need to be developed to further improve on the therapeutic perspectives for elderly patients with AML.