Frederick R. Appelbaum, MD | Authors

Unfavorable, Complex, and Monosomal Karyotypes: The Most Challenging Forms of Acute Myeloid Leukemia

August 03, 2012

Although the overall prognosis for patients with acute myeloid leukemia (AML) associated with unfavorable, complex, or monosomal karyotypes is poor, some patients can be cured.

What Pediatrics Can Teach Us

April 15, 2011

The cure of childhood acute lymphocytic leukemia (ALL) stands at the top of medicine's achievements in the struggle against cancer.

What Defines an 'Elderly Patient With AML'?

November 17, 2006

Acute myeloid leukemia (AML) is a disease of the elderly, with the majority of patients diagnosed in their 6th and 7th decade of life. Older patients with AML are less likely to achieve complete remission after induction chemotherapy, and they suffer from higher rates of leukemia relapse compared to younger cohorts. Suboptimal outcomes are the result of adverse biologic characteristics of leukemia in the elderly, as well as the presence of medical comorbidities and patient or physician preferences as to initiating treatment. In addition, there is a distinct lack of randomized, prospective data to guide management decisions for the treatment of AML in the elderly. Patients who are over age 75, with poor performance status, multiple comorbidities, or poor prognostic features, should be considered for a clinical trial or palliative therapy. Elderly patients who are candidates for standard induction chemotherapy and achieve complete remission are unlikely to benefit from intensive postremission therapy and should be referred to a clinical trial when possible. Further prospective trials are needed to identify a tolerable, effective treatment regimen for older patients with AML.