PURPOSE: High-dose intermittent cytarabine is an effective postremission treatment for patients with acute myeloid leukemia (AML). This regimen is a safe approach in patients < 60 years but produced severe neurotoxicity in the elderly. EXPERIMENTAL DESIGN: We have established a dose-reduced age-adapted consolidation using intermediate dose (IDAC; 2 x 1 g/m(2) i.v., days 1, 3, and 5) for AML patients >/= 60 years. Forty-seven de novo AML patients in complete remission (CR; median age, 70 years) were scheduled to receive four consolidation cycles of IDAC. RESULTS: In 25 of 47 patients (53%), all four cycles were administered: 9 (19%) received three cycles; 7 (15%) received two cycles; and 6 patients (12%) one cycle. Treatment was well tolerated without neurotoxicity. The median number of days with severe neutropenia (absolute neutrophil count < 500/microl) was 9. Neutropenic fever occurred in 22 of 47 patients (49%) during the first cycle, in 24 of 41 (60%) during the second, in 15 of 34 (44%) during the third, and in 18 of 25 (72%) during the fourth cycle. Only 1 patient died during consolidation (cardiac failure). The median overall survival, disease-free survival, and continuous CR were 10.6, 15.5, and 15.9 months, respectively. The probability of overall survival, disease-free survival, and continuous CR at 5 years were 18, 22, and 30%, respectively. CONCLUSIONS: IDAC is a safe and effective postremission therapy for elderly patients with AML.
PURPOSE: High-dose intermittent cytarabine is an effective postremission treatment for patients with acute myeloid leukemia (AML). This regimen is a safe approach in patients < 60 years but produced severe neurotoxicity in the elderly. EXPERIMENTAL DESIGN: We have established a dose-reduced age-adapted consolidation using intermediate dose (IDAC; 2 x 1 g/m(2) i.v., days 1, 3, and 5) for AMLpatients >/= 60 years. Forty-seven de novo AMLpatients in complete remission (CR; median age, 70 years) were scheduled to receive four consolidation cycles of IDAC. RESULTS: In 25 of 47 patients (53%), all four cycles were administered: 9 (19%) received three cycles; 7 (15%) received two cycles; and 6 patients (12%) one cycle. Treatment was well tolerated without neurotoxicity. The median number of days with severe neutropenia (absolute neutrophil count < 500/microl) was 9. Neutropenic fever occurred in 22 of 47 patients (49%) during the first cycle, in 24 of 41 (60%) during the second, in 15 of 34 (44%) during the third, and in 18 of 25 (72%) during the fourth cycle. Only 1 patient died during consolidation (cardiac failure). The median overall survival, disease-free survival, and continuous CR were 10.6, 15.5, and 15.9 months, respectively. The probability of overall survival, disease-free survival, and continuous CR at 5 years were 18, 22, and 30%, respectively. CONCLUSIONS:IDAC is a safe and effective postremission therapy for elderly patients with AML.
Authors: Wolfgang R Sperr; Susanne Herndlhofer; Karoline Gleixner; Michael Girschikofsky; Ansgar Weltermann; Sigrid Machherndl-Spandl; Thamer Sliwa; Rainer Poehnl; Veronika Buxhofer-Ausch; Karin Strecker; Gregor Hoermann; Paul Knoebl; Ulrich Jaeger; Klaus Geissler; Michael Kundi; Peter Valent Journal: Am J Hematol Date: 2017-08-17 Impact factor: 10.047
Authors: Peter Valent; Emir Hadzijusufovic; Thomas Grunt; Heidrun Karlic; Barbara Peter; Harald Herrmann; Gregor Eisenwort; Gregor Hoermann; Axel Schulenburg; Michael Willmann; Rainer Hubmann; Medhat Shehata; Edgar Selzer; Karoline V Gleixner; Thomas Rülicke; Wolfgang R Sperr; Brigitte Marian; Michael Pfeilstöcker; Hubert Pehamberger; Felix Keil; Ulrich Jäger; Christoph Zielinski Journal: Wien Klin Wochenschr Date: 2018-07-13 Impact factor: 1.704
Authors: Angélica Cuapio; Mirte Post; Sabine Cerny-Reiterer; Karoline V Gleixner; Gabriele Stefanzl; Jose Basilio; Susanne Herndlhofer; Wolfgang R Sperr; Nicolaas H C Brons; Emilio Casanova; Jacques Zimmer; Peter Valent; Erhard Hofer Journal: Oncotarget Date: 2016-07-19