Yazarlar : Pollyea DA, Zehnder J, Coutre S

Yayın : Haematologica

Yayın Yılı : 2012

Konu : Geriyatrik Hematoloji

Literatür İçeriği : Background There are limited treatment options for older patients with acute myeloid leukemia (AML) and prognosis remains poor, thereby warranting development of novel therapies. We evaluated the efficacy and safety of azacitidine in combination with lenalidomide as front-line therapy for older AML patients. Design and methods Patients >60 years of age with untreated AML received azacitidine 75mg/m2 for 7 days followed by escalating doses of lenalidomide daily for 21 days starting on day 8 of each cycle every 6 cycles. Patients received continued therapy until disease progression, unacceptable toxicity, or completion of 12 cycles. Results Forty-two patients (median age, 74 years) were enrolled with equal distribution according to ELN risk. Overall response rate was 40% (CR+CRi rate = 28%). The median time to CR/CRi was 12 weeks, and duration of CR/CRi was 28 weeks (range, 4- >104 weeks). Therapy-related AML and high hematopoietic cell transplantation comorbidity index were negative predictors of response. Early death was noted in 17% of patients. Grades ≥ 3 toxicities were uncommon and most adverse events were gastrointestinal, fatigue and myelosupression. Conclusions Sequential combination of azacitidine plus lenalidomide has clinical activity in older AML patients, and further studies of this combination are underway.

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