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Titolo:
Acute myeloid leukaemia (AML): treatment of the older patient
Autore:
Buchner, T; Hiddemann, W; Schoch, C; Haferlach, T; Sauerland, MC; Heinecke, A;
Indirizzi:
Univ Hosp, Dept Internal Med, D-48129 Munster, Germany Univ Hosp MunsterGermany D-48129 Internal Med, D-48129 Munster, Germany Univ Munich, Dept Internal Med, Munich, Germany Univ Munich Munich Germany v Munich, Dept Internal Med, Munich, Germany Univ Munster, Dept Biostat, D-4400 Munster, Germany Univ Munster MunsterGermany D-4400 ept Biostat, D-4400 Munster, Germany
Titolo Testata:
BEST PRACTICE & RESEARCH CLINICAL HAEMATOLOGY
fascicolo: 1, volume: 14, anno: 2001,
pagine: 139 - 151
SICI:
1521-6926(200103)14:1<139:AML(TO>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOGENOUS LEUKEMIA; ACUTE NONLYMPHOCYTIC LEUKEMIA; COLONY-STIMULATING FACTOR; PHASE-III TRIAL; REMISSION-INDUCTION CHEMOTHERAPY; MULTIDRUG-RESISTANCE MDR1; ACUTE MYELOCYTIC-LEUKEMIA; SOUTHWEST-ONCOLOGY-GROUP; HIGH-DOSE CYTARABINE; TREATMENT-OF-CANCER;
Keywords:
AML; older patient; daunorubicin dosage; maintenance treatment; growth factors; prognostic factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
55
Recensione:
Indirizzi per estratti:
Indirizzo: Buchner, T Univ Hosp, Dept Internal Med, Albert Schweitzer Str 33, D-48129Munster, Germany Univ Hosp Albert Schweitzer Str 33 Munster Germany D-48129 any
Citazione:
T. Buchner et al., "Acute myeloid leukaemia (AML): treatment of the older patient", BEST P R C, 14(1), 2001, pp. 139-151

Abstract

Undertreatment of the older patients with acute myeloid leukaemia (AML) can explain, in part, their inferior outcome when com pared with that of younger patients. Corresponding to the benefit to patients under the age of 60 from high-dose Ara-C there are also dose effects in those over 60 years old, in particular for daunorubicin in the induction treatment, and for the quantity in terms of duration of postremission treatment. The use of these effects can partly overcome the mostly unfavourable disease biology seen in older age AML patients, which is expressed by the absence of favourable and the over-representation of adverse chromosomal abnormalities as well as by the expression of drug resistance. We recommend an adequate dosage of 60 mg/m(2) daunorubicin for 3 days in combination with standard dose Ara-C and 6-thioguanine given for induction and consolidation, followed by a prolongedmonthly maintenance chemotherapy for a duration of at least 1 year. Further improvements in supportive care may help in delivering additional anti-leukaemic cytotoxicity. As a novel approach, non-myeloablative preparative regimens may open up the field of allogeneic transplantation for older patients with AML. Given that the actual median age in this disease is more than 60 years the management of older age AML remains as the major challenge.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/01/20 alle ore 10:56:02