Document Detail


A novel effective and safe consolidation for patients over 60 years with acute myeloid leukemia: intermediate dose cytarabine (2 x 1 g/m2 on days 1, 3, and 5).
MedLine Citation:
PMID:  15217926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: High-dose intermittent cytarabine is an effective postremission treatment for patients with acute myeloid leukemia (AML). This regimen is a safe approach in patients < 60 years but produced severe neurotoxicity in the elderly. EXPERIMENTAL DESIGN: We have established a dose-reduced age-adapted consolidation using intermediate dose (IDAC; 2 x 1 g/m(2) i.v., days 1, 3, and 5) for AML patients >/= 60 years. Forty-seven de novo AML patients in complete remission (CR; median age, 70 years) were scheduled to receive four consolidation cycles of IDAC. RESULTS: In 25 of 47 patients (53%), all four cycles were administered: 9 (19%) received three cycles; 7 (15%) received two cycles; and 6 patients (12%) one cycle. Treatment was well tolerated without neurotoxicity. The median number of days with severe neutropenia (absolute neutrophil count < 500/microl) was 9. Neutropenic fever occurred in 22 of 47 patients (49%) during the first cycle, in 24 of 41 (60%) during the second, in 15 of 34 (44%) during the third, and in 18 of 25 (72%) during the fourth cycle. Only 1 patient died during consolidation (cardiac failure). The median overall survival, disease-free survival, and continuous CR were 10.6, 15.5, and 15.9 months, respectively. The probability of overall survival, disease-free survival, and continuous CR at 5 years were 18, 22, and 30%, respectively. CONCLUSIONS: IDAC is a safe and effective postremission therapy for elderly patients with AML.
Authors:
Wolfgang R Sperr; Maria Piribauer; Friedrich Wimazal; Christa Fonatsch; Renate Thalhammer-Scherrer; Ilse Schwarzinger; Klaus Geissler; Paul Knöbl; Ulrich Jäger; Klaus Lechner; Peter Valent
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cancer research : an official journal of the American Association for Cancer Research     Volume:  10     ISSN:  1078-0432     ISO Abbreviation:  Clin. Cancer Res.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-25     Completed Date:  2005-01-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9502500     Medline TA:  Clin Cancer Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3965-71     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine I, Division of Hematology & Hemostaseology, Institute of Medical Biology, and Institute of Medical and Laboratory Medicine, Medical University of Vienna, Vienna, Austria. wolfgang.r.sperr@univie.ac.at
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antimetabolites, Antineoplastic / administration & dosage*
Antineoplastic Agents, Phytogenic / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Cytarabine / administration & dosage*
Daunorubicin / administration & dosage
Disease-Free Survival
Etoposide / administration & dosage
Female
Humans
Karyotyping
Leukemia, Myeloid, Acute / drug therapy*,  genetics
Male
Middle Aged
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antimetabolites, Antineoplastic; 0/Antineoplastic Agents, Phytogenic; 147-94-4/Cytarabine; 20830-81-3/Daunorubicin; 33419-42-0/Etoposide

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