ADULT ACUTE-LEUKEMIA - A RETROSPECTIVE STUDY OF 66 CONSECUTIVE PATIENTS

Background: Advances in therapy and supportive care have improved the outlook for many patients with acute leukaemia, however elderly patien ts have increased treatment-related toxicity and shorter survival. Mos t clinical trials have selected patient populations with young median ages and it is therefore difficult to apply results to the general pop ulation where the majority of patients presenting with acute leukaemia are over 60 years. There is little information in the literature guid ing appropriate treatment of these patients. Aims: To determine the re lationship between age, treatment received, and outcome in patients pr esenting with acute leukaemia. Methods: A retrospective analysis was p erformed on all patients presenting to Prince Henry's Hospital and Mon ash Medical Centre with acute myeloid leukaemia (AML) or acute lymphoc ytic leukaemia (ALL) during a five year period. Results: Sixty-six pat ients (51 - AML, 15 - ALL) presented with acute leukaemia between Marc h 1989 and April 1994. Median patient age was 63 years; 32% of patient s received supportive therapy only; 86% of patients with ALL and 58% o f patients with AML commencing remission-induction chemotherapy entere d a complete remission. Median survival for patients receiving only su pportive therapy was three months. Median survival in patients under 5 5 years was almost twice as long as patients over 55 years receiving s imilar treatment (AML - eight vs four months p=0.023; ALL - 3.5 vs sev en months p=0.029). Conclusions: Median survival for acute leukaemia i s inversely proportional to age. Applying results from selected series to elderly patients with acute leukaemia is inappropriate.