What are the contributing factors to poor outcomes in older patients with AML?

Published on September 26, 2017 in Treatment

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Aziz Nazha, MD
Assistant Professor, Lerner College of Medicine
Associate Staff, Taussig Cancer Institute
Cleveland Clinic
Cleveland, Ohio

Welcome to Managing AML, I am Dr. Aziz Nazha. I am frequently asked, “What are the contributing factors to poor outcomes in older patients with AML?” These factors can be divided into patient-related factors and disease-related factors. Patient-related factors are mainly related to worse performance status in patients with AML, typically older adults. Older adults with AML have more comorbidities in terms of heart, lung, liver, and other comorbidities compared to younger adults. Their metabolism of the chemotherapy is also different compared to younger adults. In terms of their disease biology, it is also different when we compare them to younger adults with AML. Older folks with AML tend to have unfavorable risk cytogenetics, they tend to have secondary acute myeloid leukemia or therapy-related acute myeloid leukemia (typically associated with worse outcome), and they tend to be resistant to current chemotherapy. The biology of their disease is different than the biology of AML in younger patients, thus their outcome typically is worse.

Last modified: September 20, 2017

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