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Prognostic factor analysis of the survival of elderly patients with AML in the MRC AML11 and LRF AML14 trials

Wheatley, Keith, Brookes, Cassandra l., Howman, Andrew J., Goldstone, Anthony H., Milligan, Donald W., Prentice, Archibald G., Moorman, Anthony V. and Burnett, Alan Kenneth 2009. Prognostic factor analysis of the survival of elderly patients with AML in the MRC AML11 and LRF AML14 trials. British Journal of Haematology 145 (5) , pp. 598-605. 10.1111/j.1365-2141.2009.07663.x

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This analysis, of 2483 patients with acute myeloid leukaemia (AML) aged 60+ years entered into two UK trials, was performed to determine the baseline parameters related to survival and to develop a risk index. The Medical Research Council (MRC) AML11 trial (n = 1071) was used to develop the index; this was validated using data from the Leukaemia Research fund (LRF) AML14 trial on 1137 intensively (AML14I) and 275 nonintensively (AML14NI) treated patients. In AML11, cytogenetic group, age, white blood count, performance status and type of AML (de novo, secondary) were all highly significantly related to prognosis in multivariate analysis. The regression coefficients were used to define good, standard and poor risk groups, with 1-year survival of 53%, 43% and 16% respectively (P < 0Æ0001). The risk index showed very good discrimination in both AML14I and AML14NI (both P < 0Æ0001), thereby providing validation, although survival in all groups was very poor in AML14NI. The risk factors for survival in older AML patients were similar to those in younger ones and discrimination of patient groups with relatively good to very poor prognosis was possible. These risk groups apply to both intensively and non-intensively treated patients. Randomized trials of intensive versus non-intensive therapy are needed to determine which types of patient should be given which type of treatment.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
Uncontrolled Keywords: acute myeloid leukaemia, elderly patients, prognostic factors, intensive therapy, non-intensive therapy
Publisher: Wiley-Blackwell
ISSN: 0007-1048
Last Modified: 25 Jun 2017 03:18

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