TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE
Objectives: Low-dose cytarabine (LD-AraC) is still regarded as the standard of care in elderly patients with acute myeloid leukemia (AML) ‘unfit’ for intensive chemotherapy. In this study, we compared the efficacy of LD-AraC, in patients ≥ 70 years old, with that of intensive chemotherapy, best supp...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2016-01-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
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| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/2409 |
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| author | Maël Heiblig Mohamed Elhamri Isabelle Tigaud Adriana Plesa Fiorenza Barraco Hélène Labussière Sophie Ducastelle Mauricette Michallet Franck Nicolini Claudiu Plesa Eric Wattel Gilles Salles Xavier Thomas |
| author_facet | Maël Heiblig Mohamed Elhamri Isabelle Tigaud Adriana Plesa Fiorenza Barraco Hélène Labussière Sophie Ducastelle Mauricette Michallet Franck Nicolini Claudiu Plesa Eric Wattel Gilles Salles Xavier Thomas |
| author_sort | Maël Heiblig |
| collection | DOAJ |
| description | Objectives: Low-dose cytarabine (LD-AraC) is still regarded as the standard of care in elderly patients with acute myeloid leukemia (AML) ‘unfit’ for intensive chemotherapy. In this study, we compared the efficacy of LD-AraC, in patients ≥ 70 years old, with that of intensive chemotherapy, best supportive care (BSC), or hypomethylating agents in a single institution experience.
Methods: Between 2000 and 2014, 60 patients received LD-AraC at 20 mg once or twice daily by subcutaneous injection for 10 consecutive days every 4-6 weeks. 85 patients were treated by intensive chemotherapy, 34 patients by hypomethylating agents, and 43 patients only by BSC.
Results: Complete remission rate with LD-AraC was 7% versus 56% with intensive chemotherapy and 21% with hypomethylating agents. Median overall survival (OS) of patients treated with LD-AraC was 9.6 months with 3-year OS of 12%. Survival with LD-AraC was better than with BSC only (P = 0.001). Although not statistically significant, intensive chemotherapy and hypomethylating agents tended to be better than LD-AraC in terms of OS (median: 12.4 months and 16.1 months, respectively). There was no clear evidence that a beneficial effect of LD-AraC was restricted to any particular subtype of patients, except for cytogenetics.
Conclusions: Despite a trend in favor of intensive chemotherapy and hypomethylating agents over LD-AraC, no real significant advantage could be demonstrated, while LD-AraC showed a significant advantage comparatively to BSC. This tends to confirm that LD-AraC can still represent a baseline against which new promising agents may be compared either alone or in combination. |
| format | Article |
| id | doaj-art-771e34dea3f946fead76ceefb1d77ecc |
| institution | Kabale University |
| issn | 2035-3006 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj-art-771e34dea3f946fead76ceefb1d77ecc2025-01-02T01:46:29ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062016-01-0180e2016009e201600910.4084/mjhid.2016.0091593TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCEMaël Heiblig0Mohamed Elhamri1Isabelle Tigaud2Adriana Plesa3Fiorenza Barraco4Hélène Labussière5Sophie Ducastelle6Mauricette Michallet7Franck Nicolini8Claudiu Plesa9Eric Wattel10Gilles Salles11Xavier Thomas12Lyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceClinique Mutualiste Lyon FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceLyon-Sud Hospital FranceObjectives: Low-dose cytarabine (LD-AraC) is still regarded as the standard of care in elderly patients with acute myeloid leukemia (AML) ‘unfit’ for intensive chemotherapy. In this study, we compared the efficacy of LD-AraC, in patients ≥ 70 years old, with that of intensive chemotherapy, best supportive care (BSC), or hypomethylating agents in a single institution experience. Methods: Between 2000 and 2014, 60 patients received LD-AraC at 20 mg once or twice daily by subcutaneous injection for 10 consecutive days every 4-6 weeks. 85 patients were treated by intensive chemotherapy, 34 patients by hypomethylating agents, and 43 patients only by BSC. Results: Complete remission rate with LD-AraC was 7% versus 56% with intensive chemotherapy and 21% with hypomethylating agents. Median overall survival (OS) of patients treated with LD-AraC was 9.6 months with 3-year OS of 12%. Survival with LD-AraC was better than with BSC only (P = 0.001). Although not statistically significant, intensive chemotherapy and hypomethylating agents tended to be better than LD-AraC in terms of OS (median: 12.4 months and 16.1 months, respectively). There was no clear evidence that a beneficial effect of LD-AraC was restricted to any particular subtype of patients, except for cytogenetics. Conclusions: Despite a trend in favor of intensive chemotherapy and hypomethylating agents over LD-AraC, no real significant advantage could be demonstrated, while LD-AraC showed a significant advantage comparatively to BSC. This tends to confirm that LD-AraC can still represent a baseline against which new promising agents may be compared either alone or in combination.http://www.mjhid.org/index.php/mjhid/article/view/2409acute myeloid leukemialow-dose cytarabinetreatmentelderlyprognosis. |
| spellingShingle | Maël Heiblig Mohamed Elhamri Isabelle Tigaud Adriana Plesa Fiorenza Barraco Hélène Labussière Sophie Ducastelle Mauricette Michallet Franck Nicolini Claudiu Plesa Eric Wattel Gilles Salles Xavier Thomas TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE Mediterranean Journal of Hematology and Infectious Diseases acute myeloid leukemia low-dose cytarabine treatment elderly prognosis. |
| title | TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE |
| title_full | TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE |
| title_fullStr | TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE |
| title_full_unstemmed | TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE |
| title_short | TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE |
| title_sort | treatment with low dose cytarabine in elderly patients age 70 years or older with acute myeloid leukemia a single institution experience |
| topic | acute myeloid leukemia low-dose cytarabine treatment elderly prognosis. |
| url | http://www.mjhid.org/index.php/mjhid/article/view/2409 |
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