BACKGROUND: The efficacy of azacitidine for the treatment of high-risk myelodysplastic syndromes has prompted the issue of its potential role even in the treatment of acute myeloid leukemia (AML). METHODS: The authors analyzed 82 patients with AML who were diagnosed according to World Health Organization criteria. The median patient age was 72 years (range, 29-87 years), and 27 patients (33%) had secondary AML. Of 62 patients with evaluable cytogenetics, 18 patients (29%) had a poor-risk karyotype, and 44 patients (71%) had an intermediate karyotype. Thirty-five patients (43%) received azacitidine as front-line treatment, and 47 patients (57%) had previously received 1 or more line of chemotherapy. RESULTS: The overall response rate was 32% (26 of 82 patients) and included 12 (15%) complete remissions (CRs), 4 (5%) CRs with incomplete blood count recovery (CRi), and 10 (12%) partial responses (PRs). Responses were observed more frequently among untreated patients compared with pretreated patients; in fact, 17 of 35 untreated patients (48%) responded, including 11 responses (31%) classified as CR/CRi. Conversely, only 9 of 47 pretreated patients (19%) responded, including 5 responses (11%) that were classified as CR/Cri. The response rate was significantly higher for untreated patients (P = .006) and those who had white blood cell counts <10 × 10(9) /L (P = .006). For untreated patients who achieved a response, the median overall response duration was 13 months, and the 1-year and 2-years overall survival rates were 58% and 24%, respectively. CONCLUSIONS: The current results indicated that azacitidine promises to be an effective therapy for elderly patients with untreated AML and with white blood cell counts <10 × 10(9) /L.
BACKGROUND: The efficacy of azacitidine for the treatment of high-risk myelodysplastic syndromes has prompted the issue of its potential role even in the treatment of acute myeloid leukemia (AML). METHODS: The authors analyzed 82 patients with AML who were diagnosed according to World Health Organization criteria. The median patient age was 72 years (range, 29-87 years), and 27 patients (33%) had secondary AML. Of 62 patients with evaluable cytogenetics, 18 patients (29%) had a poor-risk karyotype, and 44 patients (71%) had an intermediate karyotype. Thirty-five patients (43%) received azacitidine as front-line treatment, and 47 patients (57%) had previously received 1 or more line of chemotherapy. RESULTS: The overall response rate was 32% (26 of 82 patients) and included 12 (15%) complete remissions (CRs), 4 (5%) CRs with incomplete blood count recovery (CRi), and 10 (12%) partial responses (PRs). Responses were observed more frequently among untreated patients compared with pretreated patients; in fact, 17 of 35 untreated patients (48%) responded, including 11 responses (31%) classified as CR/CRi. Conversely, only 9 of 47 pretreated patients (19%) responded, including 5 responses (11%) that were classified as CR/Cri. The response rate was significantly higher for untreated patients (P = .006) and those who had white blood cell counts <10 × 10(9) /L (P = .006). For untreated patients who achieved a response, the median overall response duration was 13 months, and the 1-year and 2-years overall survival rates were 58% and 24%, respectively. CONCLUSIONS: The current results indicated that azacitidine promises to be an effective therapy for elderly patients with untreated AML and with white blood cell counts <10 × 10(9) /L.
Authors: J Desoutter; J Gay; C Berthon; L Ades; B Gruson; S Geffroy; I Plantier; A Marceau; N Helevaut; J Fernandes; M Bemba; L Stalnikiewicz; C Frimat; J Labreuche; O Nibourel; C Roumier; M Figeac; P Fenaux; B Quesnel; A Renneville; A Duhamel; C Preudhomme Journal: Leukemia Date: 2015-11-19 Impact factor: 11.528
Authors: Alison R Walker; Rebecca B Klisovic; Ramiro Garzon; Larry J Schaaf; Kristina Humphries; Steven M Devine; John C Byrd; Michael R Grever; Guido Marcucci; William Blum Journal: Leuk Lymphoma Date: 2013-09-09
Authors: Simone Thomas; Roland Schelker; Sebastian Klobuch; Sascha Zaiss; Martina Troppmann; Michael Rehli; Torsten Haferlach; Wolfgang Herr; Albrecht Reichle Journal: Haematologica Date: 2014-09-26 Impact factor: 9.941
Authors: Tapan M Kadia; Xavier G Thomas; Anna Dmoszynska; Agnieszka Wierzbowska; Mark Minden; Christopher Arthur; Jacques Delaunay; Farhad Ravandi; Hagop Kantarjian Journal: Am J Hematol Date: 2015-05-28 Impact factor: 10.047