Treating the Elderly Patient with Acute Myelogenous Leukemia

Among patients with acute myeloid leukemia (AML), treatment regimens and outcomes may differ among younger and older adults. Although there is no clear dividing line when considering age in AML, in most studies, "older adults" was defined as over age 60.The management of older patients with AML is a difficult challenge (1). Older adults are more likely to have comorbidities that can limit treatment options; disease tends to be more aggressive biologically; and outcomes are worse than in younger patients. Decisions regarding the optimal treatment of acute myelogenous leukemia in the elderly patient requires the consideration of multiple factors. Population-based studies have demonstrated that, for all age groups, aggressive therapy results in improved survival and quality of life when compared with palliative care. The optimal induction and post remission regimen for older patients has yet to be determined. Furthermore, not all patients are candidates for such therapy. Consideration of patient and disease-related factors can help to determine the appropriateness of intensive therapy in a given patient. For those patients for whom aggressive induction therapy does not seem to be in their best interest, novel agents are being investigated that will hopefully address the issues of induction death and early relapse associated with these patient populations. This topic review will discuss the treatment of older adults with AML.