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A Novel Effective and Safe Consolidation for Patients Over 60 Years with Acute Myeloid Leukemia
- Source :
- Clinical Cancer Research. 10:3965-3971
- Publication Year :
- 2004
- Publisher :
- American Association for Cancer Research (AACR), 2004.
-
Abstract
- Purpose: High-dose intermittent cytarabine is an effective postremission treatment for patients with acute myeloid leukemia (AML). This regimen is a safe approach in patients < 60 years but produced severe neurotoxicity in the elderly. Experimental Design: We have established a dose-reduced age-adapted consolidation using intermediate dose (IDAC; 2 × 1 g/m2 i.v., days 1, 3, and 5) for AML patients ≥ 60 years. Forty-seven de novo AML patients in complete remission (CR; median age, 70 years) were scheduled to receive four consolidation cycles of IDAC. Results: In 25 of 47 patients (53%), all four cycles were administered: 9 (19%) received three cycles; 7 (15%) received two cycles; and 6 patients (12%) one cycle. Treatment was well tolerated without neurotoxicity. The median number of days with severe neutropenia (absolute neutrophil count < 500/μl) was 9. Neutropenic fever occurred in 22 of 47 patients (49%) during the first cycle, in 24 of 41 (60%) during the second, in 15 of 34 (44%) during the third, and in 18 of 25 (72%) during the fourth cycle. Only 1 patient died during consolidation (cardiac failure). The median overall survival, disease-free survival, and continuous CR were 10.6, 15.5, and 15.9 months, respectively. The probability of overall survival, disease-free survival, and continuous CR at 5 years were 18, 22, and 30%, respectively. Conclusions: IDAC is a safe and effective postremission therapy for elderly patients with AML.
- Subjects :
- Cancer Research
medicine.medical_specialty
Myeloid
medicine.drug_class
business.industry
Myeloid leukemia
medicine.disease
Gastroenterology
Antimetabolite
Surgery
Regimen
Leukemia
medicine.anatomical_structure
Oncology
hemic and lymphatic diseases
Internal medicine
Absolute neutrophil count
medicine
Cytarabine
business
medicine.drug
Severe neutropenia
Subjects
Details
- ISSN :
- 15573265 and 10780432
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Clinical Cancer Research
- Accession number :
- edsair.doi...........224177af2f38f49a9f87157473597281
- Full Text :
- https://doi.org/10.1158/1078-0432.ccr-04-0185