BACKGROUND: Standard therapy for older patients with acute myeloid leukemia (AML) has a poor outcome. The authors have designed a combination of clofarabine plus low-dose cytarabine followed by a prolonged consolidation alternating with decitabine. METHODS: Sixty patients with a median age of 70 years (range, 60-81 years) with newly diagnosed AML were included. They received clofarabine 20 mg/m(2) intravenously daily for 5 days plus cytarabine 20 mg subcutaneously twice daily for 10 days. Responding patients continued for up to 17 courses of consolidation therapy including decitabine. RESULTS: Forty of 59 evaluable patients responded (66%). Complete remission rate was 58%. Median relapse-free survival (RFS) was 14.1 (95% confidence interval [CI], 6.9 to not estimable), and median overall survival (OS) was 12.7 months (95% CI, 8.8 to not estimable). Median OS of responding patients (complete response [CR]/CR with platelet count <100 × 109/L) was 24.2 months (95% CI, 17 to not estimable). Compared with a historical group of patients who received clofarabine plus low-dose cytarabine with a shorter consolidation, RFS was not statistically different. Induction mortality was low (7% at 8 weeks) and toxicities manageable. CONCLUSIONS: Clofarabine plus low-dose cytarabine alternating with decitabine in consolidation is active in older patients with newly diagnosed AML. The benefits of a prolonged consolidation remain unproven.
BACKGROUND: Standard therapy for older patients with acute myeloid leukemia (AML) has a poor outcome. The authors have designed a combination of clofarabine plus low-dose cytarabine followed by a prolonged consolidation alternating with decitabine. METHODS: Sixty patients with a median age of 70 years (range, 60-81 years) with newly diagnosed AML were included. They received clofarabine 20 mg/m(2) intravenously daily for 5 days plus cytarabine 20 mg subcutaneously twice daily for 10 days. Responding patients continued for up to 17 courses of consolidation therapy including decitabine. RESULTS: Forty of 59 evaluable patients responded (66%). Complete remission rate was 58%. Median relapse-free survival (RFS) was 14.1 (95% confidence interval [CI], 6.9 to not estimable), and median overall survival (OS) was 12.7 months (95% CI, 8.8 to not estimable). Median OS of responding patients (complete response [CR]/CR with platelet count <100 × 109/L) was 24.2 months (95% CI, 17 to not estimable). Compared with a historical group of patients who received clofarabine plus low-dose cytarabine with a shorter consolidation, RFS was not statistically different. Induction mortality was low (7% at 8 weeks) and toxicities manageable. CONCLUSIONS:Clofarabine plus low-dose cytarabine alternating with decitabine in consolidation is active in older patients with newly diagnosed AML. The benefits of a prolonged consolidation remain unproven.
Authors: Alan K Burnett; Nigel H Russell; Jonathan Kell; Michael Dennis; Donald Milligan; Stefania Paolini; John Yin; Dominic Culligan; Peter Johnston; John Murphy; Mary-Frances McMullin; Ann Hunter; Emma Das-Gupta; Richard Clark; Robert Carr; Robert K Hills Journal: J Clin Oncol Date: 2010-04-12 Impact factor: 44.544
Authors: William Blum; Ramiro Garzon; Rebecca B Klisovic; Sebastian Schwind; Alison Walker; Susan Geyer; Shujun Liu; Violaine Havelange; Heiko Becker; Larry Schaaf; Jon Mickle; Hollie Devine; Cheryl Kefauver; Steven M Devine; Kenneth K Chan; Nyla A Heerema; Clara D Bloomfield; Michael R Grever; John C Byrd; Miguel Villalona-Calero; Carlo M Croce; Guido Marcucci Journal: Proc Natl Acad Sci U S A Date: 2010-04-05 Impact factor: 11.205
Authors: Hagop M Kantarjian; Harry P Erba; David Claxton; Martha Arellano; Roger M Lyons; Tibor Kovascovics; Janice Gabrilove; Michael Craig; Dan Douer; Michael Maris; Stephen Petersdorf; Paul J Shami; Andrew M Yeager; Stephen Eckert; Rekha Abichandani; Stefan Faderl Journal: J Clin Oncol Date: 2009-12-21 Impact factor: 44.544
Authors: Utz Krug; Christoph Röllig; Anja Koschmieder; Achim Heinecke; Maria Cristina Sauerland; Markus Schaich; Christian Thiede; Michael Kramer; Jan Braess; Karsten Spiekermann; Torsten Haferlach; Claudia Haferlach; Steffen Koschmieder; Christian Rohde; Hubert Serve; Bernhard Wörmann; Wolfgang Hiddemann; Gerhard Ehninger; Wolfgang E Berdel; Thomas Büchner; Carsten Müller-Tidow Journal: Lancet Date: 2010-12-03 Impact factor: 79.321
Authors: Hagop M Kantarjian; Varsha Gandhi; Peter Kozuch; Stefan Faderl; Francis Giles; Jorge Cortes; Susan O'Brien; Nuhad Ibrahim; Fadlo Khuri; Min Du; Mary Beth Rios; Sima Jeha; Peter McLaughlin; William Plunkett; Michael Keating Journal: J Clin Oncol Date: 2003-03-15 Impact factor: 44.544
Authors: Meagan A Jacoby; Michael G Martin; Geoffrey L Uy; Peter Westervelt; John F Dipersio; Amanda Cashen; Keith Stockerl-Goldstein; Ravi Vij; Jingqin Luo; Teresa Reineck; Noel Bernabe; Camille N Abboud Journal: Am J Hematol Date: 2014-03-03 Impact factor: 10.047