Document Detail


Clofarabine plus low-dose cytarabine followed by clofarabine plus low-dose cytarabine alternating with decitabine in acute myeloid leukemia frontline therapy for older patients.
MedLine Citation:
PMID:  22282348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Standard therapy for older patients with acute myeloid leukemia (AML) has a poor outcome. The authors have designed a combination of clofarabine plus low-dose cytarabine followed by a prolonged consolidation alternating with decitabine.
METHODS: Sixty patients with a median age of 70 years (range, 60-81 years) with newly diagnosed AML were included. They received clofarabine 20 mg/m(2) intravenously daily for 5 days plus cytarabine 20 mg subcutaneously twice daily for 10 days. Responding patients continued for up to 17 courses of consolidation therapy including decitabine.
RESULTS: Forty of 59 evaluable patients responded (66%). Complete remission rate was 58%. Median relapse-free survival (RFS) was 14.1 (95% confidence interval [CI], 6.9 to not estimable), and median overall survival (OS) was 12.7 months (95% CI, 8.8 to not estimable). Median OS of responding patients (complete response [CR]/CR with platelet count <100 × 109/L) was 24.2 months (95% CI, 17 to not estimable). Compared with a historical group of patients who received clofarabine plus low-dose cytarabine with a shorter consolidation, RFS was not statistically different. Induction mortality was low (7% at 8 weeks) and toxicities manageable.
CONCLUSIONS: Clofarabine plus low-dose cytarabine alternating with decitabine in consolidation is active in older patients with newly diagnosed AML. The benefits of a prolonged consolidation remain unproven.
Authors:
Stefan Faderl; Farhad Ravandi; Xuelin Huang; Xuemei Wang; Elias Jabbour; Guillermo Garcia-Manero; Tapan Kadia; Alessandra Ferrajoli; Marina Konopleva; Gautam Borthakur; Jan Burger; Jennie Feliu; Hagop M Kantarjian
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-26
Journal Detail:
Title:  Cancer     Volume:  118     ISSN:  1097-0142     ISO Abbreviation:  Cancer     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-06     Completed Date:  2012-11-19     Revised Date:  2014-02-03    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4471-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Cancer Society.
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MeSH Terms
Descriptor/Qualifier:
Adenine Nucleotides / adverse effects,  therapeutic use*
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use*
Arabinonucleosides / adverse effects,  therapeutic use*
Azacitidine / adverse effects,  analogs & derivatives*,  therapeutic use
Consolidation Chemotherapy
Cytarabine / adverse effects,  therapeutic use*
Female
Humans
Induction Chemotherapy
Leukemia, Myeloid, Acute / drug therapy*,  mortality
Male
Middle Aged
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 CA016672/CA/NCI NIH HHS; P50 CA100632/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Adenine Nucleotides; 0/Arabinonucleosides; 04079A1RDZ/Cytarabine; 762RDY0Y2H/clofarabine; 776B62CQ27/decitabine; M801H13NRU/Azacitidine
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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