Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
| Autor: | Kanyaporn Charoenprasert, Saranya Pongudom, Yingyong Chinthammitr, Phichayut Phinyo, Klaijith Wongyai, Naiyana Panoi, Harutaya Kasyanan, Jittiporn Purattanamal, Anoree Surawong |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Palliative treatment Prednisolone elderly hydroxyurea law.invention Randomized controlled trial law Internal medicine metronomic chemotherapy Antineoplastic Combined Chemotherapy Protocols medicine Humans Adverse effect Survival analysis Aged Etoposide Acute myeloid leukemia business.industry Mercaptopurine Myeloid leukemia General Medicine Middle Aged Prognosis Metronomic Chemotherapy Alternative treatment Survival Rate Leukemia Myeloid Acute Female Open label business Research Article Follow-Up Studies |
| Zdroj: | Asian Pacific Journal of Cancer Prevention : APJCP |
| ISSN: | 2476-762X 1513-7368 |
| Popis: | Background Management of unfit AML patients is a therapeutic challenge. Most hematologists tend to avoid aggressive treatment leaving patients with a choice of best supportive care. We hypothesized that metronomic chemotherapy could be an alternative treatment for unfit AML patients. Methods A multi-center randomized controlled trial was conducted in seven university-affiliated hospitals in Thailand. Unfit AML patients were recruited and followed up from December 2014 to December 2017. Patients were randomly assigned to receive either metronomic chemotherapy or palliative hydroxyurea. Overall survival rates were compared using Cox's proportional hazard survival analysis. Results A total of 81 eligible patients were randomly allocated and included for ITT analysis. The OS rate was higher in group receiving metronomic chemotherapy than in group receiving palliative treatment at 6 and 12 months with borderline significance (6 months HR 0.60; 95%CI 0.36, 1.02; p-value 0.060; 12 months: HR 0.66; 95%CI 0.41, 1.08; p-value 0.097). Conclusion Metronomic chemotherapy could prolong survival time of unfit AML patients, especially in the first 12 months after diagnosis without increasing treatment-associated adverse events. |
| Databáze: | OpenAIRE |
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