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Results of treatment of acute myeloid leukemia and myelodysplastic syndrome with etoposide, thioguanine, cytarabine (ETC) in elderly patients.

Treatment in elderly patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) remains controversial, and results have been poor with most regimens. In order to study the efficacy of a new regimen in the treatment of these diseases in elderly patients assessed as not tolerating full-scale anthracycline-containing intensive chemotherapy, 14 patients over 60 years were enrolled in our study. The median age was 69 years, range 60-85 years. Eight patients had MDS (one transformed to AML) and six had AML. Anthracycline-lacking therapy (ETC) consisted of etoposide 120 mg/m² and thioguanine 100 mg/m² p.o. twice daily on days 1-5 and cytarabine (araC) 40 mg/m² s.c. on day 1. The preliminary results were as follows: 7 of the 14 patients (50%) achieved complete remission. The median survival was 10 months. Days spent at hospital were 28. Neutropenia was observed for 11 days and thrombocytopenia for 15 days. No severe infection was detected. Early death was observed in 2 (14%) of the patients. In conclusion, this novel treatment with a complete response of 50% appears to be a simple, safe, cost-effective form of therapy for elderly patients.