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- Title
High-dose cytarabine induction is well tolerated and active in patients with de novo acute myeloid leukemia older than 60 years.
- Authors
Arellano, Martha; Winton, Elliott; Pan, Lin; Lima, Lisa; Tighiouart, Mourad; Bhalla, Kapil; Heffner, Leonard T.; Neely, Jessica; Hutcherson, Donald; McLemore, Morgan; Langston, Amelia; Khoury, H. Jean
- Abstract
BACKGROUND: High-dose cytarabine (HiDAC) is safe and very effective in younger patients with acute myeloid leukemia (AML), but it generally is not well tolerated in the elderly. METHODS: The authors explored the safety and tolerability of a modified HiDAC induction regimen consisting of 6 daily doses of cytarabine at 2 g/m2 in combination with 3 daily doses of daunorubicin at 45 mg/m2 in 59 consecutive patients aged >60 years who had de novo AML diagnosed between July 1996 and February 2005. RESULTS: The median patient age was 68 years (range, 60-86 years). The regimen was well tolerated. Infections were common and occurred in 39% of patients, but cerebellar toxicities occurred in only 7% of patients and were reversible. The day-30 induction-related mortality rate was 10%. Overall, 69% of patients achieved complete remissions (CR), and 80% received up to 3 consolidations with HiDAC. The median follow-up for surviving patients was 53 months (range, 17-114 months). The median overall survival was 15.3 months (range, 1-114 months), and the relapse-free survival was 13.8 months (range, 1-113 months). Survival for patients who achieved CR was 27 months (range, 2-114 months). CONCLUSIONS: The modified HiDAC regimen was well tolerated in patients aged >60 years with AML and was associated with low induction mortality and high rates of CR. Nevertheless, these high remissions still were associated with poor overall outcomes. Cancer 2011;. © 2011 American Cancer Society.
- Subjects
CYTARABINE; ANTIVIRAL agents; ANTINEOPLASTIC agents; ACUTE myeloid leukemia; MYELOID leukemia
- Publication
Cancer (0008543X), 2012, Vol 118, Issue 2, p428
- ISSN
0008-543X
- Publication type
Article
- DOI
10.1002/cncr.26290