Acute Myeloid Leukemia (AML) is the Most Common Leukemia in Elderly Men
Acute myeloid leukemia (AML) is definitively the most common leukemia affecting elderly men, with a median age at diagnosis of 67 years and 54% of patients diagnosed at age ≥65 years. 1
Epidemiologic Evidence
The NCCN guidelines clearly establish AML as the predominant acute leukemia in the adult population, accounting for the largest number of annual leukemia deaths in the United States. 1
Key demographic features include:
- Median age at diagnosis is 67 years, with approximately one-third of patients diagnosed at ≥75 years of age 1
- The disease occurs most frequently in older adults, with median age ranges from 65 to 70 years across multiple studies 2
- AML represents a disease predominantly of older adults, with the highest incidence in this population 3, 4
Clinical Significance in the Elderly Population
The elderly population with AML faces distinct challenges compared to younger patients:
- Elderly patients (>60 years) have an adverse prognosis and are more susceptible to treatment complications 1
- The disease is biologically distinct in older adults, characterized by higher prevalence of poor prognostic markers, unfavorable cytogenetics, and resistance to therapy 5
- Treatment decisions are complicated not only by comorbidities but also by the high prevalence of adverse biological features including secondary AML following myelodysplastic syndrome and complex aberrant karyotypes 1
Real-World Treatment Patterns
Population-based data from the Swedish Acute Leukemia Registry demonstrates that in unselected elderly populations, 27% of patients age 65-74 and 72% of patients age >74 did not receive intensive chemotherapy. 1 Similarly, among Medicare beneficiaries older than 65, approximately 70% did not receive chemotherapy, ranging from 56% of patients age 65-74 to 94% of patients age ≥85. 1