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Survival in the Elderly with Acute Leukemia *
Author(s) -
HOLMES FREDERICK F.,
HEARNE ERWIN,
CONANT MERRILL,
GARLOW WILLIAM
Publication year - 1979
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1979.tb06124.x
Subject(s) - medicine , acute leukemia , leukemia , bone marrow , hematocrit , referral , natural history , surgery , family medicine
The natural history of acute leukemia in the elderly is not well understood. There is disagreement about the value of treatment other than by supportive measures. In this study, the survival predictive power of 9 variables was analyzed in 103 patients aged 70 or older for whom a bone‐marrow cytologic diagnosis of acute leukemia had been made at a referral hospital during the 30year period, 1947–1976. When given, treatment was uniformly conservative. Blood leukocyte and platelet counts and hematocrit values at the time of diagnosis, sex, treatment, and the calendar year of diagnosis were significant (P < 0.01) predictors of survival duration. Initial hematologic measurements, presumably reflecting the degree of leukemic cell infiltration of the bone marrow, were the strongest predictors of survival, whereas leukemic cell type had no predictive power. Survival increased significantly (P < 0.01) during the 30year period of the study, possibly more attributable to improved supportive care than to specific antileukemic therapy. Apparently survival is at least partly determined at the time of diagnosis, and conservative therapy often may be beneficial rather than detrimental.