Outcomes of Six-Dose High-Dose Cytarabine as a Salvage Regimen for Patients with Relapsed/Refractory Acute Myeloid Leukemia
| Autor: | Michael Craig, Abraham S. Kanate, Alexandra Shillingburg, Brandi Anders, Aaron Cumpston, Nilay A. Shah, Lauren Veltri |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Article Subject Gastroenterology 03 medical and health sciences 0302 clinical medicine Refractory High dose cytarabine Internal medicine Medicine Diseases of the blood and blood-forming organs business.industry Myeloid leukemia Hematology Surgery Transplantation Regimen 030104 developmental biology 030220 oncology & carcinogenesis Toxicity Relapsed refractory Clinical Study Cytarabine RC633-647.5 business medicine.drug |
| Zdroj: | Advances in Hematology, Vol 2017 (2017) Advances in Hematology |
| ISSN: | 1687-9104 |
| DOI: | 10.1155/2017/6464972 |
| Popis: | Relapsed/refractory acute myeloid leukemia (RR-AML) is associated with poor prognosis and long-term disease-free survival requires allogeneic hematopoietic cell transplantation (allo-HCT). Limited data exists, regarding the optimal regimen to obtain remission prior to allo-HCT. Single agent high-dose cytarabine (10–12 doses administered every 12 hours) has been previously used as induction therapy. Six-dose high-dose cytarabine (HiDAC-6), commonly used as a consolidation regimen, has never been evaluated as induction therapy. We present a retrospective review of 26 consecutive patients with RR-AML receiving single agent cytarabine 3 g/m2intravenously every 12 hours on days 1, 3, and 5 for a total of six doses (HiDAC-6). Median follow-up for surviving patients was 10.4 months (range 1.6–112.2 months). Complete remission was obtained in 62% (54% CR and 8% CRi) of the patients. The median relapse-free survival (RFS) was 22.3 months (range 0.7–112 months), event-free survival (EFS) was 4.7 months (range 0.5–112 months), and the overall survival (OS) was 9.6 months (range 1–112 months). Thirty-five percent of patients were able to subsequently proceed to allo-HCT. Treatment-related toxicities included neutropenic fever (38%), infection (35%), neurotoxicity (8%), and skin toxicity (8%). This is the first study to demonstrate HiDAC-6 as an active treatment option for younger patients with RR-AML which can effectively serve as a bridge to allo-HCT without significant toxicity. |
| Databáze: | OpenAIRE |
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