Abstract：
:Most patients above 60 years with acute myeloid leukemia (AML) will die from their disease. Nevertheless, the treatment concepts in elderly patients with myelodysplastic syndromes (MDS) and AML are rapidly evolving. A number of recent reports have identified better survival rates with intensive induction chemotherapy for patients up to 80 years, with the exception of patients with unfavorable genomic risk abnormalities or with major co-morbidities. Gemtuzumab ozogamicin is increasingly added to induction therapy for AML patients up to 70 years with favorable or intermediate risk profile, and Midostaurin for patients with a FLT3 mutation. The recommended dose of daunorubicin is 60 mg/m2 for 3 + 7 induction therapy. Elderly patients with acute promyelocytic leukemia should receive all-trans retinoic acid and arsenic trioxide, and cytotoxic treatment is limited upfront to patients with initial leukocytosis. Allogeneic transplantation can be recommended to selected patients up to 70-75 years. For patients unfit for intensive treatment, therapeutic options comprise a hypomethylating agent (HMA), low-dose cytarabin and supportive care. HMA treatment is also increasingly applied for relapsed/refractory AML after intensive chemotherapy. A considerable number of candidate compounds are currently being studied in older AML patients, with their potential role in the treatment of elderly AML patients remaining to be clarified.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
Mueller BU,Seipel K,Pabst Tdoi
10.1016/j.ejim.2018.05.026subject
Has Abstractpub_date
2018-12-01 00:00:00pages
28-32eissn
0953-6205issn
1879-0828pii
S0953-6205(18)30222-Xjournal_volume
58pub_type
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journal_title：European journal of internal medicine
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abstract：:Microchimerism is defined by the presence within an individual of a low level of cells derived from another individual. Systemic sclerosis is clinically similar to chronic graft-versus-host disease, a known condition of chimerism, which has led some authors to explore the hypothesis that microchimerism may contribute ...
journal_title：European journal of internal medicine
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journal_title：European journal of internal medicine
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