Azacitidine Prolongs Overall Survival Compared With Conventional Care Regimens in Elderly Patients With Low Bone Marrow Blast Count Acute Myeloid Leukemia
Top Cited Papers
- 1 February 2010
- journal article
- research article
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 28 (4), 562-569
- https://doi.org/10.1200/jco.2009.23.8329
Abstract
Purpose: In a phase III randomized trial, azacitidine significantly prolonged overall survival (OS) compared with conventional care regimens (CCRs) in patients with intermediate-2– and high-risk myelodysplastic syndromes. Approximately one third of these patients were classified as having acute myeloid leukemia (AML) under current WHO criteria. This analysis compared the effects of azacitidine versus CCR on OS in this subgroup. Patients and Methods: Patients were randomly assigned to receive subcutaneous azacitidine 75 mg/m2/d or CCR (best supportive care [BSC] only, low-dose cytarabine (LDAC), or intensive chemotherapy [IC]). Results: Of the 113 elderly patients (median age, 70 years) randomly assigned to receive azacitidine (n = 55) or CCR (n = 58; 47% BSC, 34% LDAC, 19% IC), 86% were considered unfit for IC. At a median follow-up of 20.1 months, median OS for azacitidine-treated patients was 24.5 months compared with 16.0 months for CCR-treated patients (hazard ratio = 0.47; 95% CI, 0.28 to 0.79; P = .005), and 2-year OS rates were 50% and 16%, respectively (P = .001). Two-year OS rates were higher with azacitidine versus CCR in patients considered unfit for IC (P = .0003). Azacitidine was associated with fewer total days in hospital (P < .0001) than CCR. Conclusion: In older adult patients with low marrow blast count (20% to 30%) WHO-defined AML, azacitidine significantly prolongs OS and significantly improves several patient morbidity measures compared with CCR.Keywords
This publication has 36 references indexed in Scilit:
- Acute Leukemia in Patients Sixty Years of Age and OlderAmerican Journal of Clinical Oncology, 2009
- Acute Myeloid Leukemia in the ElderlySeminars in Oncology, 2008
- Acute myeloid leukemia in the elderly: Conventional and novel treatment approachesBlood Reviews, 2008
- Intensive chemotherapy is not recommended for patients aged >60 years who have myelodysplastic syndromes or acute myeloid leukemia with high‐risk karyotypesCancer, 2007
- Effects of Initial Treatment on Survival among Elderly AML Patients: Findings from the SEER-Medicare Database.Blood, 2006
- Age and acute myeloid leukemiaBlood, 2006
- Results of intensive chemotherapy in 998 patients age 65 years or older with acute myeloid leukemia or high‐risk myelodysplastic syndrome:Cancer, 2006
- The Outcomes and Costs of Acute Myeloid Leukemia Among the ElderlyArchives of Internal Medicine, 2002
- Gemtuzumab ozogamicin with or without interleukin 11 in patients 65 years of age or older with untreated acute myeloid leukemia and high-risk myelodysplastic syndrome: comparison with idarubicin plus continuous-infusion, high-dose cytosine arabinosideBlood, 2002
- Acute Myeloid LeukemiaNew England Journal of Medicine, 1999