Thalidomide in Combination with Chemotherapy in Treating Elderly Patients with Acute Myeloid Leukemia

Autor:	Chen Chen, Wei Xu, Jing Yang
Rok vydání:	2018
Předmět:	Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Kaplan-Meier Estimate 03 medical and health sciences 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor Outcome Assessment Health Care medicine Humans Prospective Studies Chemotherapy-Induced Febrile Neutropenia Aclarubicin Prospective cohort study Aged Proportional Hazards Models Aged 80 and over Chemotherapy Proportional hazards model business.industry Remission Induction Cytarabine Myeloid leukemia Hematology Middle Aged Thalidomide Regimen 030104 developmental biology Leukemia Myeloid 030220 oncology & carcinogenesis Acute Disease Female business medicine.drug
Zdroj:	Oncology Research and Treatment. 41:461-465
ISSN:	2296-5262 2296-5270
Popis:	Background: Currently, the treatment decisions in elderly patients with acute myeloid leukemia (AML) are difficult and remain controversial. This study aims to evaluate the effect of thalidomide plus chemotherapy on elderly patients with AML. Methods: 70 elderly AML patients (median age 71 years) were enrolled into this prospective study and randomly assigned to either the control arm (PC, n = 35) or the investigational arm (TPC, n = 35). Patients in the PC arm received a non-intensive regimen composed of cytarabine, aclarubicin and G-CSF (CAG) chemotherapy for induction of remission, and patients in the TPC arm received in addition thalidomide at a maximum dose of 200 mg/day. Results: After 2 courses of induction therapy, complete response rate of TPC and PC arms was 54.3% and 57.1%, respectively (p = 0.810). At the last follow-up, the Kaplan-Meier estimate showed that the median overall survival (OS) and event-free survival (EFS) in patients in the PC arm was inferior to those of patients in the TPC arm. Using a stratified Cox model adjusted for randomized treatment, patients receiving thalidomide plus chemotherapy were shown to derive some survival benefit in both OS and EFS. Overall, the hematological and non-hematological toxicity were similar between the 2 treatment arms. Conclusions: Thalidomide in combination with chemotherapy is an alternative treatment option for elderly patients with AML.
Databáze:	OpenAIRE
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