Oral Chemotherapeutic Agents in Elderly Acute Myeloid Leukemia (AML) Patients,a Study from Developin

来源 :BIT‘s2nd Annual World Cancer Congess-2009 (2009第二届癌症大会) | 被引量 : 0次 | 上传用户:hulisheng
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  Background: Almost 60% of the patients with Acute Myeloid Leukemia (AML) are over the age of 60 years.Age is one of the strongest adverse prognostic factors for AML, both for induction remission and for survival.Studies have shown that elderly patients have reduced tolerance to aggressive chemotherapy especially the myelosupressive effects.Elderly patients with Leukemia who received intensive treatment often die as a result of chemotherapy.Aggressive chemotherapy is also costly which the relatives in developing country are reluctant to spend for the elderly patients.The aim of our study was to see the tolerability and cost effectiveness of oral chemotherapeutic agents.Material & Methods: We selected consecutive 100 patients more than 50 years of age in haemato oncology department ofNCRI (Netaji Subhas Chandra Bose Cancer Research Institute) during the period from Jan 2004 to Dec 2006.The mean age of the patients was 65 (range 50-71) years.There was male preponderance.The inclusion criteria were performance status more than 60% (Komofsky), Morphological, Cyto-Chemical and Immunophenotyping diagnosis of Acute Myeloid Leukemia (AML), normal liver (billirubine < 2) and kidney function (Creatinine <2%).After the incent consent all patient were started oral chemotherapeutic agents 6 Mercptopurine (6MP) 75mg/m2.Etoposide 70mg/m2 and Prednisolone 40mg/m2.All agents are given 3 weeks followed by 7 days gap every month and continued for 6 months.Bone Marrow was repeated after 3rd & 6th course of chemotherapy.Results: Fifteen (15%) and thirtyeight patients (3 8%) had complete hematological response after 3rd & 6th course of chemotherapy.Seven patients (7%) died because of grade Ⅲ/Ⅳ Neutropenia.Median duration of Myelosupression was 18 days (2 to 48 days).12% required hospitalisation.With median follow up of 19 months (range 2-36 months) the disease free survival (DFS) and over all survival (OS) was 18 % and 32 % respectively.Conclusions: The combination of oral chemotherapeutic agents consisting of 6MP, Etoposide & Prednisolone was well tolerated by elderly patients with good induction remission, low mortality and median survival.It was cheaper and well accepted by the patients.
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