Azacitidine might be beneficial in a subgroup of older AML patients compared to intensive chemotherapy: a single centre retrospective study of 227 consecutive patients

Journal of Hematology & Oncology

Gerwin Huls³  Edo Vellenga³  Eva van den Berg²  André B Mulder¹  Simon MGJ Daenen³  Nic JGM Veeger³  Ellen RM Scheepers³  Lieke H van der Helm³ 

[1] Department of Laboratory Medicine, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands;Department of Haematology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands

关键词: Best supportive care;    Intensive chemotherapy;    Azacitidine;    Older age;    Acute myeloid leukaemia;   

Others  :  812160
DOI  :  10.1186/1756-8722-6-29

 received in 2013-01-31, accepted in 2013-04-05,  发布年份 2013

【 摘 要 】

Background

Treatment options in older acute myeloid leukaemia (AML) patients include intensive chemotherapy, best supportive care (BSC), and hypomethylating agents. Currently, limited data is available on hypomethylating agents in older AML patients in unselected patient populations.

Methods

To compare the effectiveness of azacitidine with conventional therapy, we collected data of 227 consecutive AML patients (≥60 years) who were treated with azacitidine (N = 26), intensive chemotherapy (N = 90), or BSC (N = 97).

Results

Azacitidine-treated patients were older and had more comorbidities, but lower white blood cell- and bone marrow blast counts compared with intensive chemotherapy patients. Complete or partial response was achieved in 42% of azacitidine-treated patients and in 73% of intensive chemotherapy patients (P = 0.005). However, the overall survival (OS) was similar (1-year-OS 57% versus 56%, P = 0.93; 2-year-OS 35% versus 35%, P = 0.92), and remained similar after correction for risk factors in a multivariate analysis. Patients treated with BSC had an inferior OS (1-year- and 2-year-OS 16% and 2%, P < 0.001). Compared to intensive chemotherapy, azacitidine-treated patients spent less days in the hospital (median in first three months 0.5 versus 56, P < 0.001), and needed less red blood cell and platelet transfusions (median per month 2.7 versus 7, P < 0.001 and 0.3 versus 5, P < 0.001) in the first three months.

Conclusions

Azacitidine treatment is associated with a comparable OS but higher tolerability in a subgroup of older AML patients compared with intensive chemotherapy. Patients receiving BSC had a poor prognosis.

【 授权许可】

   
2013 van der Helm et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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