Azacitidine and low-dose cytarabine in palliative patients with acute myeloid leukemia and high bone marrow blast counts - a retrospective single-center experience

European Journal of Haematology

Volumn 93, Issue 2, 2014, Pages 112-117

  Radujkovic, Aleksandar ^a   Dietrich, Sascha ^a   Bochtler, Tilmann ^a   Krämer, Alwin ^a,b   Schöning, Tilman ^a   Ho, Anthony D ^a   Dreger, Peter ^a   Luft, Thomas ^a  

^a UNIVERSITY HOSPITAL HEIDELBERG   (Germany)

^b GERMAN CANCER RESEARCH CENTER DKFZ   (Germany)

Author keywords

Acute myeloid leukemia; Azacitidine; Cytarabine; Retrospective

Indexed keywords

AZACITIDINE; CYTARABINE; HEMOGLOBIN; ANTINEOPLASTIC AGENT;

ACUTE GRANULOCYTIC LEUKEMIA; ADULT; AGED; ARTICLE; BLEEDING; BONE MARROW BLAST COUNT; BONE MARROW CELL; CANCER PALLIATIVE THERAPY; CELL COUNT; CYTOGENETICS; DONOR LYMPHOCYTE INFUSION; DRUG EFFICACY; DRUG SAFETY; FEBRILE NEUTROPENIA; FEMALE; GENETIC RISK; HEMATOLOGICAL PARAMETERS; HUMAN; LEUKOCYTE; LOW DRUG DOSE; MAJOR CLINICAL STUDY; MALE; OVERALL SURVIVAL; PNEUMONIA; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SURVIVAL RATE; THROMBOCYTE COUNT; TREATMENT RESPONSE; BONE MARROW; CHEMICALLY INDUCED; DRUG ADMINISTRATION; DRUG EFFECTS; GENETICS; KARYOTYPING; LEUKEMIA, MYELOID, ACUTE; MIDDLE AGED; MORTALITY; NEUTROPENIA; PALLIATIVE THERAPY; PATHOLOGY; SURVIVAL; VERY ELDERLY;

ADULT; AGED; AGED, 80 AND OVER; ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; AZACITIDINE; BONE MARROW; CYTARABINE; DRUG ADMINISTRATION SCHEDULE; FEMALE; HEMORRHAGE; HUMANS; KARYOTYPING; LEUKEMIA, MYELOID, ACUTE; MALE; MIDDLE AGED; NEUTROPENIA; PALLIATIVE CARE; PNEUMONIA; RETROSPECTIVE STUDIES; SURVIVAL ANALYSIS;

EID: 84904307346     PISSN: 09024441     EISSN: 16000609     Source Type: Journal    
DOI: 10.1111/ejh.12308     Document Type: Article

References (26)

1. Löwenberg B, Downing JR, Burnett A. Acute myeloid leukemia. N Engl J Med 1999;341:1051-62.
2. Martino M, Fedele R, Moscato T, Ronco F. Optimizing outcomes following allogeneic hematopoietic progenitor cell transplantation in AML: the role of hypomethylating agents. Curr Cancer Drug Targets 2013;13:661-9.
3. Estey E. Acute myeloid leukemia and myelodysplastic syndromes in older patients. J Clin Oncol 2007;25:1908-15.
4. Kantarjian H, O'brien S, Cortes J, et al. Results of intensive chemotherapy in 998 patients age 65 years or older with acute myeloid leukemia or high-risk myelodysplastic syndrome: predictive prognostic models for outcome. Cancer 2006;106:1090-8.
5. Kantarjian H, Ravandi F, O'Brien S, et al. Intensive chemotherapy does not benefit most older patients (age 70 years or older) with acute myeloid leukemia. Blood 2010;116:4422-9.
6. Fröhling S, Schlenk RF, Kayser S, Morhardt M, Benner A, Döhner K, Döhner H; German-Austrian AML Study Group. Cytogenetics and age are major determinants of outcome in intensively treated acute myeloid leukemia patients older than 60 years: results from AMLSG trial AML HD98-B. Blood 2006;108:3280-8.
7. Fathi AT, Abdel-Wahab O. Mutations in epigenetic modifiers in myeloid malignancies and the prospect of novel epigenetic-targeted therapy. Adv Hematol 2012;2012:469592.
8. Bhalla KN. Epigenetic and chromatin modifiers as targeted therapy of hematologic malignancies. J Clin Oncol 2005;23:3971-93.
9. Garcia-Manero G. Demethylating agents in myeloid malignancies. Curr Opin Oncol 2008;20:705-10.
10. Fenaux P, Mufti GJ, Hellstrom-Lindberg E, et al. Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study. Lancet Oncol 2009;10:223-32.
11. Fenaux P, Mufti GJ, Hellström-Lindberg E, et al. Azacitidine prolongs overall survival compared with conventional care regimens in elderly patients with low bone marrow blast count acute myeloid leukemia. J Clin Oncol 2010;28:562-9.
12. Grimwade D, Hills RK, Moorman AV, Walker H, Chatters S, Goldstone AH, Wheatley K, Harrison CJ, Burnett AK; National Cancer Research Institute Adult Leukaemia Working Group. Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials. Blood 2010;116:354-65.
13. Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for Diagnosis, Standardization of Response Criteria, Treatment Outcomes, and Reporting Standards for Therapeutic Trials in Acute Myeloid Leukemia. J Clin Oncol 2003;21:4642-9. Erratum in: J Clin Oncol. 2004;22:576.
14. Cheson BD, Bennett JM, Kantarjian H, et al. Report of an international working group to standardize response criteria for myelodysplastic syndromes. Blood 2000;96:3671-4.
15. Maurillo L, Venditti A, Spagnoli A, et al. Azacitidine for the treatment of patients with acute myeloid leukemia: report of 82 patients enrolled in an Italian Compassionate Program. Cancer 2012;118:1014-22.
16. Thepot S, Itzykson R, Seegers V, et al. Azacytidine (AZA) as first line therapy in AML: results of the French ATU Program. Blood (ASH Annual Meeting Abstracts) 2009;114: Abstract 843.
17. van der Helm LH, Veeger NJ, Kooy Mv, et al. Azacitidine results in comparable outcome in newly diagnosed AML patients with more or less than 30% bone marrow blasts. Leuk Res 2013;37:877-82.
18. Hellström-Lindberg E, Robèrt KH, Gahrton G, Lindberg G, Forsblom AM, Kock Y, Ost A. A predictive model for the clinical response to low dose ara-C: a study of 102 patients with myelodysplastic syndromes or acute leukaemia. Br J Haematol 1992;81:503-11.
19. Detourmignies L, Wattel E, Laï JL, Bauters F, Fenaux P. Is there still a role for low-dose cytosine arabinoside in de novo acute myeloid leukemia in the elderly? A report on 77 cases. Ann Hematol 1993;66:235-40.
20. Burnett AK, Milligan D, Prentice AG, Goldstone AH, McMullin MF, Hills RK, Wheatley K. A comparison of low-dose cytarabine and hydroxyurea with or without all-trans retinoic acid for acute myeloid leukemia and high-risk myelodysplastic syndrome in patients not considered fit for intensive treatment. Cancer 2007;109:1114-24.
21. Miller KB, Kim K, Morrison FS, Winter JN, Bennett JM, Neiman RS, Head DR, Cassileth PA, O'Connell MJ. The evaluation of low-dose cytarabine in the treatment of myelodysplastic syndromes: a phase-III intergroup study. Ann Hematol 1992;65:162-8.
22. Fenaux P, Gattermann N, Seymour JF, et al. Prolonged survival with improved tolerability in higher-risk myelodysplastic syndromes: azacitidine compared with low dose ara-C. Br J Haematol 2010;149:244-9.
23. van der Helm LH, Scheepers ER, Veeger NJ, Daenen SM, Mulder AB, van den Berg E, Vellenga E, Huls G. Azacitidine might be beneficial in a subgroup of older AML patients compared to intensive chemotherapy: a single centre retrospective study of 227 consecutive patients. J Hematol Oncol 2013;6:29.
24. Ozbalak M, Cetiner M, Bekoz H, Atesoglu EB, Ar C, Salihoglu A, Tuzuner N, Ferhanoglu B. Azacitidine has limited activity in 'real life' patients with MDS and AML: a single centre experience. Hematol Oncol 2012;30:76-81.
25. Isabella C, Avanzini P, Merli F. 5-Azacitidine in patients with myelodysplasia and acute myeloid leukemia: a single center experience. Blood (ASH Annual Meeting Abstracts) 2010;116: Abstract 4969.
26. Sudan N, Rossetti JM, Shadduck RK, Latsko J, Lech JA, Kaplan RB, Kennedy M, Gryn JF, Faroun Y, Lister J. Treatment of acute myelogenous leukemia with outpatient azacitidine. Cancer 2006;107:1839-43.