Levels of care: Defining best supportive care in elderly patients with acute myeloid leukemia Review uri icon

Overview

MeSH Major

  • Health Services for the Aged
  • Leukemia, Myeloid

abstract

  • This article reviews published data on best supportive care (BSC) in older patients with acute myeloid leukemia (AML) and proposes improvements in defining this critical aspect of treatment. A clinical challenge is to prospectively identify patients who could benefit from existing therapies and to optimize their treatment tolerance by improving BSC. Advanced age and poor performance status consistently emerge as reliable indicators of poor outcome in older AML patients and have historically been the most important variables used to stratify treatment. Performance status is notoriously difficult to assess, and a "snapshot" view at the time of initial presentation can be misleading. Comorbidity scales may be a better predictor of outcome, but studies looking at their effectiveness are variable. New methods are needed to stratify patients. Although the prognosis of older AML patients is generally dismal, selected patients benefit from treatment and can have prolonged survival. Because it has never been shown that BSC as a sole therapeutic approach is kinder, less expensive, or better for older AML patients, it should be reserved for select clinical situations.

publication date

  • April 2010

Research

keywords

  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1007/s11899-010-0048-8

PubMed ID

  • 20425402

Additional Document Info

start page

  • 95

end page

  • 100

volume

  • 5

number

  • 2