Studies on Leukemia in the Old

1. Clinical Studies on Hypoplastic Leukemia in the Old

Abstract

Hypoplastic leukemia has been found to be frequently seen in the old, however, its clinical characteristics in leukemia in the old are still obsqure. In the present study, clinical and hematological findings of 17 hypoplastic acute myelocytic leukemia (AML) in the old were compared with those of 25 typical AML in the old in order to evaluate its clinical characteristics. In hypoplastic AML in the old, physical findings such as fever, bleeding tendency, splenomegaly and lymphadenopathy were tended to be less frequent. The leukocytopenia, the low percentage of leukemic cells and the relative lymphocytosis and monocytosis in the peripheral blood were thought to be characteristic. The relative erythroid hyperplasia with maturation arrest and the increase of type III sideroblast in the bone marrow were also recognized in hypoplastic cases. In cases without the systemic chemotherapy, the median survival from the presumptive onset of leukemia were 12.0 months in hypoplastic cases and 2.5 months in typical cases, respectively. In cases with the systemic chemotherapy the median survival of hypoplastic cases was 8.0 months. On the other hand, it was 6.5 months in typical cases. These findings suggest the presence of the relationship between hypoplastic AML in the old and smoldering acute leukemia. On the basis of present results, hypoplastic AML in the old are thought to be different from typical AML in the old in respects of not only clinical and hematological findings but also the response to chemotherapy. The stratification by the hypoplasia in bone marrow should be done in order to establish the optimal chemotherapeutic regimen for acute leukemia in the old.