Management of Acute Myeloid Leukemia Patients Old than 60 Years in Casablanca: A Great Challenge in Developing Countries
Cancer Research Journal
Volume 6, Issue 3, September 2018, Pages: 74-78
Received: Mar. 15, 2018;
Accepted: Apr. 2, 2018;
Published: May 28, 2018
Views 332 Downloads 21
Romaric Mahutondji Massi, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Mouna Lamchahab, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Bienvenu Houssou, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Nheza Hda, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Nisrine Khoubila, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Siham Cherkaoui, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Bouchra Oukkache, Department of Haematology Laboratory, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Asmaa Quessar, Department of Haematology and Paediatric Oncology, Faculty of Medecine and Pharmacy, Hassan II University, Casablanca, Morocco
Follow on us
Introduction: AML is the most common form of acute leukemia in adults, accounting for 25% of leukemias in this population in the Western world. The characteristics of AML in the elder patients are different from those in young patients characterized by a high prevalence of poor prognosis cytogenetic abnormalities. All these factors make AML in patients older than 60 years to be an particular entity wich management is very difficult in developing countries. Data on this group of AML patients are rare in our context and the Morocco national AML-MA 2011 protocol wich is use for the treatement of AML is limited for patients aged less than 60 years. The aim of our study was to describe the epidemiological, clinical, biological characteristics of AML patients aged over 60 in the departement and to highlight the dificulties wich occurred in their management. Patients and method: A retrospective study was conducted from 1 January 2003 to 1 January 2016 including, all cases of AML patients olders than 60 years, diagnosed according to WHO criteria. Conventional cytogenetics was made in RGH band on medullary or blood samples. Results: 266/1741 (15.28%) cases were recorded during the study. The median age was 70 years (61-98ans) and the sex ratio was 1.12. The median leukocyte count at diagnosis was 33,891 / mm3 (450-347000). 52/266 (20%) patients had hyperleucocytosis more than 50G/L at diagnosis. The mean hemoglobin level at diagnosis was 6.4 g / dl (3-10.3d / dl), the mean platelet count was 76525mm3 (5000-262000) 52/266 (20%) had hyperleucocytosis. 140 patients (52.6%) had a karyotype of which 3% favorable prognosis, 67% intermediate prognosis, and 30% unfavorable prognosis. Conclusion: AML patients old than 60 years represent an important part of AML patients in the departement. Their characteristics are the same like in literature with a dominance of intermediate prognosis group. Very few are treated with intensive chemotherapy in our series.
Acute Myeloid Leukemia, Older, Characteristics, Management, Difficulties
To cite this article
Romaric Mahutondji Massi,
Management of Acute Myeloid Leukemia Patients Old than 60 Years in Casablanca: A Great Challenge in Developing Countries, Cancer Research Journal.
Vol. 6, No. 3,
2018, pp. 74-78.
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
B. Deschler, G. Ihorst, M. Kuhn, B. Ruter, M. Lubbert. Geriatric assessment: a prospective study in older patients with AML and high-risk MDS. Critical Reviews in Oncology/Hematology 60 (2006): 26-7
Barbara B. Roger. Advances in the management of Acute Myeloid Leukemia in Older Adults Patients. Oncology Nursing ForumVol. 37, No. 3, May 2010: 168-179.
S. S. Farag, K. J. Archer, K. Mrozek, A. S. Ruppert, A. J. Carroll, J. W. Cardiman and al. “Pretreatment Cytogenics Add to Other Prognostic Factors Predicting Complete Remission and Long-Term Outcome in Patients 60 Years of Age or Older With Acute Myeloid Leukemia: Results From Cancer and Leukemia Group B 8461. 2006, Blood, 108, p. 68.
Frederick R. Appelbaum, Holly Gundacker, David R. Head, Marilyn L. Slovak, Cheryl L. Willman, John E. Godwin, and al. Age and acute myeloid leukemia. Blood, 1 may 2006 volume 107, number 9: 3481-5.
Yancik R. Cancer burden in the aged: an epidemiologic and demographic overview. Cancer 1997 Oct 1; 80(7):1273-83.
Mauritson N, Johansson B, Albin M, et al. Survival time in a population-based consecutive series of adult acute myeloid leukemia: the prognostic impact of karyotype during the time period 1976-1993. Leukemia 2000; 14:1039-43.
Semochkin SV, Tolstykh TN, Arkhipova NV, Ivanova VL, Kliueva OV, Lunin VV and al. Clinical and epidemiological characteristics of acute myeloid leukemias in adults according to the data of municipal hematology departments in Moscow. Ter Arkh. 2015; 87(7):26-32.
Kathryn JACKSON, Glen KENNEDY, Peter MOLLEE, Paula MARLTON and Kirk MORRIS. Intensive chemotherapy and reduced-intensity allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia in elderly patients. Asia-Pacific Journal of Clinical Oncology 2014; 10: 246–254.
Zhao XL, Liu KQ, Lin D, Wei H, Wang Y, Zhou CLand al. Characteristics of karyotypes and gene mutations for elder acute myeloid leukemia. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2015 Apr; 23(2):300-5.
Marcucci G, Maharry K, Radmacher MD, Mrózek K, Vukosavljevic T and al. Prognostic significance of, and gene and microRNA expression signatures associated with, CEBPA mutations in cytogenetically normal acute myeloid leukemia with high-risk molecular features: a Cancer and Leukemia Group B Study. J Clin Oncol. 2008 Nov 1; 26(31):5078-87.
Becker HGanser A, Marcucci G, Maharry K, Radmacher MD, Mrózek K, Margeson D and al. Favorable prognostic impact of NPM1 mutations in older patients with cytogenetically normal de novo acute myeloid leukemia and associated gene- and microRNA-expression signatures: a Cancer and Leukemia Group B study. J Clin Oncol. 2010 Feb 1; 28(4):596-604.
Port M, Böttcher M, Thol F, Schlenk R, Wasem J, and al. Prognostic significance of FLT3 internal tandem duplication, nucleophosmin 1, and CEBPA gene mutations for acute myeloid leukemia patients with normal karyotype and younger than 60 years: a systematic review and meta-analysis. Ann Hematol. 2014 Aug; 93(8):1279-86.
Yanada M, Naoe T. Acute myeloid leukemia in older adults. Int J Hematol. 2012 Aug; 96(2):186-93.
Ferrara F. Conventional chemotherapy or hypomethylating agents for older patients with acute myeloid leukaemia? Hematol Oncol. 2014 Mar; 32(1):1-9.
Tawfik B, Sliesoraitis S, Lyerly S, Klepin HD, Lawrence J, Isom S. Efficacy of the hypomethylating agents as frontline, salvage, or consolidation therapy in adults with acute myeloid leukemia (AML). Ann Hematol. 2014 Jan; 93(1):47-55.