High dose cytarabine and mitoxantrone: an effective induction regimen for high-risk acute myeloid leukemia (AML)
| Autor: | Margaret Green, Richard A. Larson, Olatoyosi Odenike, Michael J. Thirman, Devika Gajria, Christopher K. Daugherty, Koen van Besien, Wendy Stock, Sarah Larson, Dorothy A. Sipkins, Lucy A. Godley, Dezheng Huo, Sandeep Gurbuxani, Andrew S. Artz, Howie Lawrence Weiner, Nicholas P. Campbell, Elizabeth Hyjek, Yanming Zhang |
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| Rok vydání: | 2011 |
| Předmět: |
Oncology
Adult Diarrhea Male Risk Cancer Research medicine.medical_specialty Daunorubicin Kaplan-Meier Estimate Infections Myeloid Neoplasm Young Adult High dose cytarabine Recurrence Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Transplantation Homologous Aged Retrospective Studies Aged 80 and over Chromosome Aberrations Mitoxantrone Dose-Response Relationship Drug business.industry Remission Induction Cytogenetics Cytarabine Myeloid leukemia Neoplasms Second Primary Hematology Middle Aged Prognosis Combined Modality Therapy Hematologic Diseases Neoplasm Proteins Regimen fms-Like Tyrosine Kinase 3 Leukemia Myeloid Immunology Acute Disease Female business medicine.drug Stem Cell Transplantation |
| Zdroj: | Leukemialymphoma. 53(3) |
| ISSN: | 1029-2403 |
| Popis: | Patients with high-risk AML, defined as those with advanced age, relapsed/refractory disease, unfavorable molecular and cytogenetic abnormalities, therapy-related myeloid neoplasm (t-MN) and multiple medical co-morbidities tend to respond poorly to standard cytarabine and daunorubicin induction therapy and have a poor prognosis. We performed a retrospective analysis of an alternative induction regimen using high dose cytarabine (HiDAC) and mitoxantrone (MITO) administered to 78 high-risk patients with AML at The University of Chicago from 2001 to 2008. The primary endpoints of the study were complete remission (CR) rate and death within 30 days of initiation of treatment. The median age was 63 years (range:23-85); 27% of these patients had a Charlson co-morbidity index (CCI)2. Forty-three (56%) patients had unfavorable cytogenetics, 28 (37%) had intermediate-risk cytogenetics and 5 (7%) had favorable cytogenetics. The CR rate was 45% and the CRi rate 10%; 7 patients (9%) died during induction. Notably, t-MN and relapsed/refractory patients had CR and induction death rates equivalent to de novo AML patients within this series. In this high risk AML population, HiDAC/MITO induction demonstrated an overall response rate of 55% with a low induction death rate of 9% and allowed 32 (41%) patients to proceed to allogeneic stem cell transplant. |
| Databáze: | OpenAIRE |
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