Por favor, use este identificador para citar o enlazar a este item:
http://hdl.handle.net/10261/180217
COMPARTIR / EXPORTAR:
SHARE CORE BASE | |
Visualizar otros formatos: MARC | Dublin Core | RDF | ORE | MODS | METS | DIDL | DATACITE | |
Título: | Azacitidine improves clinical outcomes in older patients with acute myeloid leukaemia with myelodysplasia-related changes compared with conventional care regimens |
Autor: | Seymour, John F.; Döhner, Hartmut; Butrym, Aleksandra; Wierzbowska, Agnieszka; Selleslag, Dominik; Jang, Jun Ho; Kumar, Rajat; Cavenagh, James; Schuh, Andre C.; Candoni, Anna; Récher, Christian; Sandhu, Irwindeep; Bernal del Castillo, Teresa; Al-Ali, Haifa Kathrin; Falantes-González, José Francisco CSIC ORCID; Stone, Richard M.; Minden, Mark D.; Weaver, Jerry; Songer, Steve; Beach, C. L.; Dombret, Hervé | Palabras clave: | Azacitidine Low-dose cytarabine Acute myeloid leukemia AML Myelodysplasia-related changes AML‐MRC Induction chemotherapy Response Survival |
Fecha de publicación: | 14-dic-2017 | Editor: | BioMed Central | Citación: | BMC Cancer 17: 852 (2017) | Resumen: | [Background] Compared with World Health Organization-defined acute myeloid leukaemia (AML) not otherwise specified, patients with AML with myelodysplasia-related changes (AML-MRC) are generally older and more likely to have poor-risk cytogenetics, leading to poor response and prognosis. More than one-half of all older (≥65 years) patients in the phase 3 AZA-AML-001 trial had newly diagnosed AML-MRC. [Methods] We compared clinical outcomes for patients with AML-MRC treated with azacitidine or conventional care regimens (CCR; induction chemotherapy, low-dose cytarabine, or supportive care only) overall and within patient subgroups defined by cytogenetic risk (intermediate or poor) and age (65–74 years or ≥75 years). The same analyses were used to compare azacitidine with low-dose cytarabine in patients who had been preselected to low-dose cytarabine before they were randomized to receive azacitidine or CCR (ie, low-dose cytarabine). [Results] Median overall survival was significantly prolonged with azacitidine (n = 129) versus CCR (n = 133): 8.9 versus 4.9 months (hazard ratio 0.74, [95%CI 0.57, 0.97]). Among patients with intermediate-risk cytogenetics, median overall survival with azacitidine was 16.4 months, and with CCR was 8.9 months (hazard ratio 0.73 [95%CI 0.48, 1.10]). Median overall survival was significantly improved for patients ages 65–74 years treated with azacitidine compared with those who received CCR (14.2 versus 7.3 months, respectively; hazard ratio 0.64 [95%CI 0.42, 0.97]). Within the subgroup of patients preselected to low-dose cytarabine before randomization, median overall survival with azacitidine was 9.5 months versus 4.6 months with low-dose cytarabine (hazard ratio 0.77 [95%CI 0.55, 1.09]). Within the low-dose cytarabine preselection group, patients with intermediate-risk cytogenetics who received azacitidine had a median overall survival of 14.1 months versus 6.4 months with low-dose cytarabine, and patients aged 65–74 years had median survival of 14.9 months versus 5.2 months, respectively. Overall response rates were similar with azacitidine and CCR (24.8% and 17.3%, respectively), but higher with azacitidine versus low-dose cytarabine (27.2% and 13.9%). Adverse events were generally comparable between the treatment arms. [Conclusions] Azacitidine may be the preferred treatment for patients with AML-MRC who are not candidates for intensive chemotherapy, particularly patients ages 65–74 years and those with intermediate-risk cytogenetics. [Trial registration] This study was registered at clinicalTrials.gov on February 16, 2010 (NCT01074047). |
Versión del editor: | https://doi.org/10.1186/s12885-017-3803-6 | URI: | http://hdl.handle.net/10261/180217 | DOI: | 10.1186/s12885-017-3803-6 | E-ISSN: | 1471-2407 |
Aparece en las colecciones: | (IBIS) Artículos |
Ficheros en este ítem:
Fichero | Descripción | Tamaño | Formato | |
---|---|---|---|---|
myeloid_leukaemia.pdf | 1,85 MB | Adobe PDF | Visualizar/Abrir |
CORE Recommender
PubMed Central
Citations
26
checked on 03-may-2024
SCOPUSTM
Citations
49
checked on 06-may-2024
WEB OF SCIENCETM
Citations
44
checked on 23-feb-2024
Page view(s)
191
checked on 07-may-2024
Download(s)
145
checked on 07-may-2024