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  • Author: Mikkael A. Sekeres x
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Mikkael A. Sekeres

Acute myeloid leukemia is a disease of older adults, with a median age at diagnosis of 68 years. This group represents a high-risk population, because inherent disease characteristics predict for resistance to chemotherapy and advanced age is accompanied by high treatment-related mortality. Standard remission-induction and postremission therapy can result in a median disease-free survival of 10 months and rare long-term survival. Efforts to improve outcomes have not made a major impact on complete remission rates of 40% to 60%, or on overall survival. Newer therapies, divided into aggressive and nonaggressive approaches, focus on targeting the disease biology specific to older adults and on maximizing quality of life. Clinical trials should be considered at every stage of treatment in this group of patients.

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Mikkael A. Sekeres

The incidence rate of the myelodysplastic syndromes (MDS) in the United States is approximately 3.4 per 100,000 people, accounting for more than 10,000 new diagnoses annually and an estimated 60,000 people living with the disease. Common risk factors for developing MDS include advanced age, male gender, and antecedent exposure to chemotherapy or radiation as treatment for other cancers, which alone accounts for 10% of MDS cases. Patients with MDS typically are diagnosed when they are in their 70s, have significant cytopenias, and have substantive transfusion needs. Erythropoiesis stimulating agents are used by more than 50% of patients, although the use of disease-modifying agents is increasing, and may ultimately have an impact on the number of patients living with MDS.