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No patient required treatment discontinuation due to toxicities of the treatment. Table 1 Baseline characteristics along with Kaplan�CMeier and Cox regression www.selleckchem.com/products/Fludarabine(Fludara).html survival analysis for the subgroups of elderly acute myeloid leukemia patients Figure 1 Kaplan�CMeier survival analysis of elderly acute myeloid leukemia patients by age group Discussion MCT is based on more frequent and low-dose drug administration as compared to conventional chemotherapy.[9] MCT targets tumor angiogenesis which is necessary for tumor growth and metastasis. The anti-angiogenic activity of MCT has been demonstrated in vivo, and several other mechanisms of action have also been recognized. These include selective inhibition of proliferation and/or induction of apoptosis of activated endothelial cells, selective inhibition of endothelial cell migration, increase in the expression level of the endogenous angiogenesis inhibitor thrombospondin-1, and sustained decrease in levels and viability of bone marrow-derived endothelial progenitor cells.[10] One more proposed mechanism is the induction of senescence in tumors achieved by repetitive, low-dose regimens of cytostatic drugs including oral 6-mercaptopurine.[11] AML in elderly patients has been recognized to be a disease of very poor prognosis and lower tolerance see more to conventional treatment options. Thus, there have been some recent reports of the trial of MCT in treatment of elderly AML.[12,13] In most of these reports, there has been the use of low-dose cytarabine which requires subcutaneous administration 2 times a day and given 4 days Dabigatran in a week.[14] However, the basic principle of MCT is to prefer oral drug which can be given continuously without any interruption. Keeping this in mind, oral 6-mercatopurine was given in our trial continuously without any scheduled interruption. In our study, 59.4% of patients had ECOG PS of 2 while rest had the status of 3. As per the guidelines of the National Comprehensive Cancer Network, low-intensity therapy, or palliation only is recommended for older AML patients with ECOG > 2.[8] Thus, the patient profile was suitable for noncurative intent treatment. The median age of the patients was 69 years with the range being 61�C86 years. In Surveillance, Epidemiology, and End Results (SEER) analysis of 5480 older AML patients by Oran and Weisdorf,[15] the median age was 78 years, range 65�C93 years and the median OS was 2 months in the untreated group versus 6 months in the treated group (P