ACUTE LYMPHOBLASTIC-LEUKEMIA IN PATIENTS OVER 59 YEARS OF AGE - EXPERIENCE IN A SINGLE-CENTER OVER A 10-YEAR PERIOD

We report data of 29 consecutive patients aged 60 years or older with newly diagnosed acute lymphoblastic leukemia (ALL) treated at a single center between 1983 and 1992. Immunophenotyping was per formed in 26 patients. According to the immunological classification used at the ti me of diagnosis, 14 had common-ALL, two had T-ALL, six had null-ALL, t hree had myeloid antigen-positive ALL with both lymphoid and myeloid m arkers, and one had B-ALL. One patient died before therapy could be in stituted. Twenty-four patients received intensive induction chemothera py. Nine of these patients died during the first 8 weeks, eight due to infections and one due to liver failure after asparaginase. In 14 of the remaining patients treated intensively, scheduled treatment was di scontinued prematurely due to treatment-related toxicity and was repla ced by milder chemotherapy. Four patients aged 75-77 years were treate d with vincristine and prednisone. Only one patient who completed a wh ole study protocol survived more than 5 years. Twelve of the 28 patien ts treated with chemotherapy achieved complete remissions. The median survival was 5 months (range 1-103+). Median survival in patients with CR was 9.0 months. Actuarial survival is 3%. Our data demonstrate a p oor prognosis in ALL patients over 59 years of age. The reasons were a high mortality during intensive induction therapy due to toxicity of treatment and a short remission duration.