Back to Search
Start Over
Prognostic Value of Genetic Alterations in Elderly Patients with Acute Myeloid Leukemia: A Single Institution Experience.
- Source :
- Cancers; Apr2019, Vol. 11 Issue 4, p570, 1p
- Publication Year :
- 2019
-
Abstract
- Although the outcome in younger adults with acute myeloid leukemia (AML) has improved, the benefit associated with standard intensive chemotherapy in older patients remains debatable. In this study, we investigated the incidence and the prognostic significance of genetic characteristics according to treatment intensity in patients aged 60 years or older. On the 495 patients of our cohort, DNMT3AR882 (25.2%), NPM1 (23.7%) and FLT3-ITD (16.8%) were the most frequent molecular mutations found at diagnosis. In this elderly population, intensive chemotherapy seemed to be a suitable option in terms of early death and survival, except for normal karyotype (NK) NPM1−FLT3-ITD+ patients and those aged over 70 within the adverse cytogenetic/molecular risk group. The FLT3-ITD mutation was systematically associated with an unfavorable outcome, independently of the ratio. NK NPM1+/FLT3-TKD+ genotype tends to confer a good prognosis in patients treated intensively. Regarding minimal residual disease prognostic value, overall survival was significantly better for patients achieving a 4 log NPM1 reduction (median OS: 24.4 vs. 12.8 months, p = 0.013) but did not reach statistical significance for progression free survival. This retrospective study highlights that intensive chemotherapy may not be the most appropriate option for each elderly patient and that molecular markers may help treatment intensity decision-making. [ABSTRACT FROM AUTHOR]
- Subjects :
- ACUTE myeloid leukemia treatment
CARCINOGENESIS
CANCER chemotherapy
CANCER patients
DEATH
GENETIC polymorphisms
MOLECULAR biology
GENETIC mutation
SURVIVAL
TUMOR markers
DECISION making in clinical medicine
ACUTE myeloid leukemia
DISEASE incidence
RETROSPECTIVE studies
DESCRIPTIVE statistics
GENOTYPES
OLD age
PROGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 20726694
- Volume :
- 11
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Cancers
- Publication Type :
- Academic Journal
- Accession number :
- 136238383
- Full Text :
- https://doi.org/10.3390/cancers11040570