Prognostic significance of risk group stratification in elderly patients with acute myeloid leukaemia

Prognostic factors were studied in a series of 211 acute myeloid leukaemia (AML) patients over 60 years of age, treated at a single centre. The patien ts were allocated into three risk groups based on cytogenetics, occurrence of antecedent haematological disorder and leucocyte count. Only 3% had low- risk features, 39% had intermediate- and 58% had adverse-risk features. Com plete remission (CR) was achieved in 43% of all patients. In multivariate a nalyses, the number of cycles needed to achieve CR and the risk group were significantly associated with the duration of CR. Median survival time for the entire cohort of patients was only 107 d. Advanced age, low induction t reatment intensity; treatment during earlier years and adverse-risk group w ere associated with shorter overall survival times. Risk group classificati on may help selection of elderly patients with a good chance of benefiting from intensive treatment to actually receive such treatment, while sparing others with a low probability of survival benefit from toxic treatment. Low intensity induction treatment reduces the chance of obtaining complete rem ission, produces inferior survival times and should consequently be avoided when the aim is to obtain complete remission. In elderly AML patients, int roducing age and re-evaluation of intermediate and good prognosis patients regarding response to induction treatment may improve the risk group classi fication.