To investigate clinical management of acute nonlymphocytic leukemia (ANLL) in the aged, the chemotherapeutic effects of aclarubicin (ACR) were studied in 20 ANLL patients (M1 5, M2 3, M4 5, M5b 6, M6 1). All patients were over 70 years old. The ratio of male to female was 16 : 4 and age ranged from 70 to 84 years old (mediam : 76y/o). Nineteen patients were untreated, one case had previous treament and 2 patients showed hypoplastic marrow on admission. ACR was administered by intravenous drip infusion at a dose of 14mg/m2/day for 7-10 days and repeated after recovery of myelosuppression. Eight patients (40%) obtained complete remission (CR) : 1 of 5 M1 (20%), 3 of 5 M4 (60%), 4 of 6 M5b (66.7%) and none of M2 or M6. CR ratio was 44% in 18 typical ANLL patients excluding the two patients with hypoplastic marrow, who did not attain CR. The duration of CR was from 1.3 to 11.3 months (median : 7.3 months) and survial time ranged from 6.6 to 15.6 months (median : 11.8 months) in patients with CR. Although side effects on the digestive system such as nausea, vomiting and anorexia were seen in 11 of 20 patients, these effects were controllable. None of the patients showed cardiac toxicity. ACR is expected to be useful in the clinical management of ANLL in patients over 70 years old, especially for M4 and 5 in the aged.
acute leukemia in the aged