Hui Liu1, Rong Fu1, Lijuan Li1, Guojin Wang1, Jia Song1, Erbao Ruan1, Huaquan Wang1, Yuhong Wu1, Xiaoming Wang1, Kai Ding1, Zonghong Shao2. 1. Department of Hematology, Tianjin Medical University General Hospital, 154 Anshan Street, Heping District, Tianjin, 300052, People's Republic of China. 2. Department of Hematology, Tianjin Medical University General Hospital, 154 Anshan Street, Heping District, Tianjin, 300052, People's Republic of China. shaozonghong@163.com.
Abstract
BACKGROUND AND OBJECTIVES: The therapy in elderly patients with acute myeloid leukemia (AML) is a big challenge because of poor risk factors and inferior tolerance to intensive chemotherapy. This study aims to compare the efficacy between reduced-intensity idarubicin plus cytarabine and daunorubicin plus cytarabine (IA regimen and DA regimen, respectively) in elderly patients with newly diagnosed AML. METHODS: We retrospectively investigated 74 patients with newly diagnosed non-M3 AML aged >60 years, where 33 patients received IA regimen, 30 patients received DA regimen, while 11 patients received supportive treatment. We observed the complete remission (CR) rates, overall survival (OS) and side effects in different arms. RESULTS: The CR rate in IA arm (70.4 %, 19/27) was significantly higher than that in DA arm (40 %, 10/25) in de novo AML (p = 0.028), and further significantly higher when white blood cell (WBC) count >10 × 109/L (p = 0.042) and ECOG (Eastern Cooperative Oncology Group) score <2 (p = 0.021). The overall survival of the entire population was poor with a median survival of 10 months, 1- and 2-year survival rates were 40.5 % (30/74) and 9.5 % (7/74). The median survival of the patients with chemotherapy was 12 months, which was significantly longer than patients treated supportively (4 months) (p < 0.001). There were no differences of median survival and duration of CR between two arms. Early mortality decreased in the past 5 years in both groups. Meanwhile, low-dose idarubicin was well tolerated in elderly patients. CONCLUSIONS: Reduced-intensity chemotherapy offered an improvement in survival, and the reduced-intensity IA regimen could improve CR rate in elderly patients with de novo AML.
BACKGROUND AND OBJECTIVES: The therapy in elderly patients with acute myeloid leukemia (AML) is a big challenge because of poor risk factors and inferior tolerance to intensive chemotherapy. This study aims to compare the efficacy between reduced-intensity idarubicin plus cytarabine and daunorubicin plus cytarabine (IA regimen and DA regimen, respectively) in elderly patients with newly diagnosed AML. METHODS: We retrospectively investigated 74 patients with newly diagnosed non-M3 AML aged >60 years, where 33 patients received IA regimen, 30 patients received DA regimen, while 11 patients received supportive treatment. We observed the complete remission (CR) rates, overall survival (OS) and side effects in different arms. RESULTS: The CR rate in IA arm (70.4 %, 19/27) was significantly higher than that in DA arm (40 %, 10/25) in de novo AML (p = 0.028), and further significantly higher when white blood cell (WBC) count >10 × 109/L (p = 0.042) and ECOG (Eastern Cooperative Oncology Group) score <2 (p = 0.021). The overall survival of the entire population was poor with a median survival of 10 months, 1- and 2-year survival rates were 40.5 % (30/74) and 9.5 % (7/74). The median survival of the patients with chemotherapy was 12 months, which was significantly longer than patients treated supportively (4 months) (p < 0.001). There were no differences of median survival and duration of CR between two arms. Early mortality decreased in the past 5 years in both groups. Meanwhile, low-dose idarubicin was well tolerated in elderly patients. CONCLUSIONS: Reduced-intensity chemotherapy offered an improvement in survival, and the reduced-intensity IA regimen could improve CR rate in elderly patients with de novo AML.
Authors: Arti Hurria; Kayo Togawa; Supriya G Mohile; Cynthia Owusu; Heidi D Klepin; Cary P Gross; Stuart M Lichtman; Ajeet Gajra; Smita Bhatia; Vani Katheria; Shira Klapper; Kurt Hansen; Rupal Ramani; Mark Lachs; F Lennie Wong; William P Tew Journal: J Clin Oncol Date: 2011-08-01 Impact factor: 44.544
Authors: B Löwenberg; R Zittoun; H Kerkhofs; U Jehn; J Abels; L Debusscher; C Cauchie; M Peetermans; G Solbu; S Suciu Journal: J Clin Oncol Date: 1989-09 Impact factor: 44.544
Authors: J M Bennett; D Catovsky; M T Daniel; G Flandrin; D A Galton; H R Gralnick; C Sultan Journal: Ann Intern Med Date: 1985-09 Impact factor: 25.391
Authors: Thomas Büchner; Wolfgang Hiddemann; Wolfgang Berdel; Bernhard Wörmann; Claudia Schoch; Helmut Löffler; Torsten Haferlach; Andrea Schumacher; Peter Staib; Leopold Balleisen; Andreas Grüneisen; Herbert Rasche; Carlo Aul; Axel Heyll; Eva Lengfelder; Wolf-Dieter Ludwig; Georg Maschmeyer; Hartmut Eimermacher; Jochen Karow; Norbert Frickhofen; Wolf-Dietrich Hirschmann; Maria-Cristina Sauerland Journal: Rev Clin Exp Hematol Date: 2002-03
Authors: Robert K Stuart; Larry D Cripe; Michael B Maris; Maureen A Cooper; Richard M Stone; Shaker R Dakhil; Francesco Turturro; Wendy Stock; James Mason; Paul J Shami; Stephen A Strickland; Luciano J Costa; Gautam Borthakur; Glenn C Michelson; Judith A Fox; Richard D Leavitt; Farhad Ravandi Journal: Br J Haematol Date: 2014-11-17 Impact factor: 6.998
Authors: Mikkael A Sekeres; Gordon Guyatt; Gregory Abel; Shabbir Alibhai; Jessica K Altman; Rena Buckstein; Hannah Choe; Pinkal Desai; Harry Erba; Christopher S Hourigan; Thomas W LeBlanc; Mark Litzow; Janet MacEachern; Laura C Michaelis; Sudipto Mukherjee; Kristen O'Dwyer; Ashley Rosko; Richard Stone; Arnav Agarwal; L E Colunga-Lozano; Yaping Chang; QiuKui Hao; Romina Brignardello-Petersen Journal: Blood Adv Date: 2020-08-11