Document Detail


A new intensive induction schedule, including high-dose Idarubicin, high-dose Aracytin and Amifostine, in older AML patients: feasibility and long-term results in 42 patients.
MedLine Citation:
PMID:  17588476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We evaluated the feasibility of a new regimen in elderly patients with acute myeloid leukemia (AML). The main end points were overall response rate (ORR) and toxicity; secondary end points were feasibility of peripheral blood stem cells (PBSC) collection, leukemia-free survival, and overall survival (OS). PATIENTS AND METHODS: We treated 42 fit elderly patients with high-dose (HD) idarubicin plus HD-cytarabine (Ara-C), with amifostine. RESULTS: We observed one treatment-related death (2%). The main extrahematological toxicity was represented by grade III to IV infections in 64% of patients. Hematological toxicity was acceptable with 15 days (range, 9-29 days) to reach >500 x 10(6)/L absolute neutrophil count and 16 days (range, 3-39 days) to achieve an unsupported platelet count >20,000 x 10(6)/L. Median duration of severe neutropenia was 12 days (range, 1-36) and median number of febrile days and intravenous antibiotics therapy was 6 (range, 0-17) and 17 days (range, 0-34), respectively, Median duration of hospitalization was 31 days (range, 20-61). ORR was 83% (34 of 41); 32 patients received intensive consolidation therapy; 15 patients were able to mobilize a sufficient number of CD34+ cells; and 14 were transplanted. CONCLUSION: According to the intention to treat criteria all patients were analyzed for outcomes. Five-year OS was 19%, with median follow-up of 38 months. Patients with unfavorable cytogenetic and those with secondary AML had poorer OS; about 40% of patients could mobilize a sufficient amount of PBSC for autologous stem cell transplantation.
Authors:
Attilio Olivieri; Debora Capelli; Emanuela Troiani; Antonella Poloni; Mauro Montanari; Massimo Offidani; Giancarlo Discepoli; Pietro Leoni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Experimental hematology     Volume:  35     ISSN:  0301-472X     ISO Abbreviation:  Exp. Hematol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-08-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0402313     Medline TA:  Exp Hematol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1074-82     Citation Subset:  IM    
Affiliation:
Department of Hematology, Medical School, University of Ancona, Ancona, Italy. attilo.olivieri@ospedalesancarlo.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Amifostine / administration & dosage,  adverse effects
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Cytarabine / administration & dosage,  adverse effects
Female
Humans
Idarubicin / administration & dosage,  adverse effects
Leukemia, Myeloid, Acute / drug therapy*
Male
Middle Aged
Treatment Outcome
Chemical
Reg. No./Substance:
147-94-4/Cytarabine; 20537-88-6/Amifostine; 58957-92-9/Idarubicin

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