The approach to the elderly patient with acute myeloid leukemia.

Acute myeloid leukemia (AML) in elderly patients is more likely to result from stem cell dysfunction at an earlier stage of myeloid maturation in the bone marrow than AML in younger individuals. The intensive therapy thought necessary to successfully treat such a relatively resistant leukemia is poorly tolerated in older patients who have more limited ability to withstand the myelosuppressive and end-organ toxicities of standard induction programs. While the administration of hematopoietic growth factors may stimulate leukemic cell growth, such a strategy could serve to ameliorate the prolonged myelosuppression associated with intensive chemotherapy, thereby outweighing this risk and offering the potential to more safely deliver such treatment to elderly patients with AML.