Literatür Detay Bilgisi
Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia.
Yazarlar : Quintás-Cardama A, Ravandi F et al
Yayın : Blood.
Yayın Yılı : 2012
Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/23071272
Konu : Geriyatrik Hematoloji
Literatür İçeriği :
Abstract
We reviewed the outcome of 671 patients with newly-diagnosed AML aged 65 or older treated at our institution between 2000 and 2010 with intensivechemotherapy (n=557) or azacitidine- or decitabine-based therapy (n=114). Both groups were balanced according to cytogenetics and performance status. The complete response (CR) rates with chemotherapy and epigenetic therapy were 42% and 28% (p=0.001) and the 8-week mortality 18% and 11% (p=0.075). Two-year relapse-free survival rates (28% vs 39%, p=0.843) and median survival (6.7 vs 6.5 months, p=0.413) were similar in both groups. Multivariate analysis identified older age, adverse cytogenetics, poor performance status, elevated creatinine, peripheral blood and bone marrow blasts, and hemoglobin, but not type of AML therapy, as independent prognostic factors for survival. No outcome differences were observed according to cytogenetics, FLT3 mutational status, age, and performance status by therapy type. Decitabine was associated with improved median overall survival compared with azacitidine (5.5 vs 8.8 months, p=0.03). Survival post failure of intensive chemotherapy, azacitidine, or decitabine was more favorable in patients who had previously received decitabine (1.1 vs 0.9 vs 3.1 months, p=0.109). In conclusion, epigenetic therapy is associated with similar survival rates compared with intensive chemotherapy in older patients with newly diagnosed AML. Two studies were registered with clinicaltrials.gov: 2009-0172 (NCT00926731) and 2009-0217 (NCT00952588)Konusu Aynı Olan Diğer Materyaller
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