Evaluating the Impact of the Addition of Cladribine to Standard Acute Myeloid Leukemia Induction Therapy
| Autor: | Salil Goorha, Nathan D. Seligson, Elizabeth L Mills, Joanna M Leonard, Athena L V Hobbs, Amy G Evans |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Antineoplastic Agents Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Induction therapy Antineoplastic Combined Chemotherapy Protocols medicine Drug approval Humans Idarubicin Pharmacology (medical) Propensity Score Cladribine Aged Retrospective Studies business.industry Remission Induction Cytarabine Myeloid leukemia Middle Aged Leukemia Myeloid Acute Treatment Outcome 030220 oncology & carcinogenesis Female business 030215 immunology medicine.drug |
| Zdroj: | Annals of Pharmacotherapy. 52:439-445 |
| ISSN: | 1542-6270 1060-0280 |
| DOI: | 10.1177/1060028017749214 |
| Popis: | Background: Treatment for acute myeloid leukemia (AML) has remained relatively unchanged over the past few decades. Although recent drug approvals have provided an increase in the number of treatment options in AML, further optimization of standard induction therapy is still necessary. The most commonly utilized induction options have been well studied, but there is a paucity of literature comparing the combination of idarubicin with cytarabine and cladribine. Objective: To assess the clinical effectiveness of the addition of cladribine to idarubicin and cytarabine (7+3 IA) induction therapy in the treatment of AML. Methods: This retrospective, propensity score–matched cohort study evaluated 37 patients with previously untreated AML who received either 7+3 IA or idarubicin, cytarabine, and cladribine (7+3+5 IAC) as induction therapy. The primary end point of this study was complete response (CR), with secondary end points including hospital length of stay (LOS), and adverse event rates. Results: After propensity score matching, odds of reaching CR in the 7+3+5 IAC cohort were increased by 33% (95% CI = 1.09-1.55; P < 0.01) compared with the 7+3 IA cohort. Patients who received cladribine were also found to have a reduction in hospital LOS by 3.5 days (95% CI = 0.07-6.85; P = 0.045) without an increase in adverse event rates. Conclusion: The addition of cladribine to the 7+3 IA regimen may improve clinical outcomes when used as initial induction therapy, without increasing the incidence of adverse event rates. |
| Databáze: | OpenAIRE |
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