مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
Myelodysplastic syndromes and acute myeloid leukemia in the elderly: epidemiology, diagnosis and treatment
Myelodysplastic syndromes and acute myeloid leukemia in the elderly: epidemiology, diagnosis and treatment
Najme Zamani,1,*Hamid Yazdani nejad,2
1. MSC student in medical surgical nursing, Nursing and Midwifery school, Kashan University of Medical Sciences,Kashan, Iran 2. Department of Operating Room and Anesthesiology, School of Allied Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Introduction: Myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) are serious blood cancers predominantly affecting the elderly. MDS involves ineffective blood cell production and may progress to AML, a rapidly advancing cancer with excessive immature cells in bone marrow and blood. Their incidence rises with age due to lifelong exposure to environmental risks, genetic mutations, and weakened immunity. Elderly patients often face additional health problems, have lower treatment tolerance, and experience more complications, leading to poorer outcomes. With the world’s aging population, it is crucial to enhance knowledge about the epidemiology, diagnostic methods, and therapies for these conditions. This study reviews existing research to clarify these aspects in older adults with MDS and AML.
Methods: This Systematic review covers keywords “myelodysplastic syndromes,” “acute myeloid leukemia,” “elderly,” “epidemiology,” “diagnosis,” and “treatment.” In SID,Scopus,PubMed,Google Scholar databases. Studies between 2015-2025 were included. Studies were included if they addressed epidemiological data, diagnostic approaches, or treatment outcomes in patients aged 60 years and above .486 articles were selected. After removing duplicate articles, articles with keywords in the title or abstract of the article and the full article file was available (26 articles) were evaluated using the PRISMA check list.
Results: Epidemiological data confirm that the incidence of MDS and AML significantly rises after age 70, driven by genetic mutations accumulation, immune senescence, and prolonged exposure to environmental toxins like benzene and pesticides. Prior radiation and pre-existing blood disorders further increase risk. Diagnosis is complicated by nonspecific symptoms, often attributed to aging, and coexisting conditions such as cardiovascular and kidney diseases. Standard treatment includes hypomethylating agents (azacitidine, decitabine) that improve hematopoiesis and delay AML progression. Allogeneic stem cell transplantation is a high-risk but potential option for selected elderly patients. Despite advances, outcomes remain poorer than in younger patients due to frailty, comorbidities, and treatment intolerance. Optimizing early detection, comprehensive assessment, and individualized therapy is essential to enhance prognosis in the elderly.
Conclusion: MDS and AML in the elderly require nuanced diagnostic and therapeutic approaches that account for physiological age and comorbidities. Ongoing research into less toxic therapies and personalized medicine approaches is crucial to improving outcomes in this growing patient group.