ACUTE MYELOID LEUKEMIA IN OLDER PATIENTS: COMPARISON OF THE EFFECTIVENESS OF THERAPY AND SURVIVAL ANALYSIS ?A SINGLE CENTER EXPERIENCE.
(Abstract release date: 05/19/16)
EHA Library. Kapelko-Slowik K. 06/09/16; 134574; PB1674
Assoc. Prof. Katarzyna Kapelko-Slowik
Contributions
Contributions
Abstract
Abstract: PB1674
Type: Publication Only
Background
Acute myeloid leukemia (AML) is disease of older adults with median age over 65 years. The effect of age and severe comorbidities are associated with high incidence of early death, low rate of complete remission (CR) and poor survival. Treatment options for elderly patients include: intensive chemotherapy, less-intensive regimens, best supportive care as well as enrollment in clinical trials. Therapeutic decisions in older AML patients are highly challenging and need to be individualized since the outcome in this group remains still unsatisfactory.
Aims
The aim of the study was to compare results of different treatment strategies in elderly patients with AML and to analyze overall survival in examined patients.
Methods
Patients. We describe a single center experience of 101 patients (41 females and 60 males) with diagnosis of AML, hospitalized in the Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University between 2007 and 2014. Median age was 70,6 years (range, 60-90 years). In 85 patients AML was diagnosed de novo, whereas 16 patients had secondary AML. Adverse, intermediate and favorable karyotype was found in 14, 82 and 5 patients, respectively. All patients were enrolled into therapeutic procedures according to the age, karyotype, performance status and comorbidity index. Fifty-five patients were treated with intensive chemotherapy regimen based on daunorubicin and cytarabine (DA, “3+ 5-7”), 22 patients obtained azacitidine (AZA), 14 patients were treated with low-dose cytarabine (LDAC), and only 10 patients received best supportive care (BSC). We estimated percent of CR, early mortality rate, leukemia free survival (LFS) and overall survival (OS).
Results
CR was achieved in 24 patients (44%) who received DA, and in 10 patients (28%) with less-intensive therapy. LFS was comparable in both these groups (5 vs 4 months), but superior in patients who received DA. Eight-week early mortality rate was up to 15% after intensive induction therapy and 10% after AZA and LDAC regimens. Nevertheless, median OS in patients treated with DA was marginally superior (5 month) than in patients who received low intensive treatment (4 month) and significantly longer than in patients with BSC (1 month).
Conclusion
The DA regimen remains still a best standard therapy in older AML patients with good performance status and low comorbidity index. Low-intensive treatment strategies (azacitidine, low-dose cytarabine) seem to be good therapeutic options for older patients with severe comorbidities.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Chemotherapy
Type: Publication Only
Background
Acute myeloid leukemia (AML) is disease of older adults with median age over 65 years. The effect of age and severe comorbidities are associated with high incidence of early death, low rate of complete remission (CR) and poor survival. Treatment options for elderly patients include: intensive chemotherapy, less-intensive regimens, best supportive care as well as enrollment in clinical trials. Therapeutic decisions in older AML patients are highly challenging and need to be individualized since the outcome in this group remains still unsatisfactory.
Aims
The aim of the study was to compare results of different treatment strategies in elderly patients with AML and to analyze overall survival in examined patients.
Methods
Patients. We describe a single center experience of 101 patients (41 females and 60 males) with diagnosis of AML, hospitalized in the Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University between 2007 and 2014. Median age was 70,6 years (range, 60-90 years). In 85 patients AML was diagnosed de novo, whereas 16 patients had secondary AML. Adverse, intermediate and favorable karyotype was found in 14, 82 and 5 patients, respectively. All patients were enrolled into therapeutic procedures according to the age, karyotype, performance status and comorbidity index. Fifty-five patients were treated with intensive chemotherapy regimen based on daunorubicin and cytarabine (DA, “3+ 5-7”), 22 patients obtained azacitidine (AZA), 14 patients were treated with low-dose cytarabine (LDAC), and only 10 patients received best supportive care (BSC). We estimated percent of CR, early mortality rate, leukemia free survival (LFS) and overall survival (OS).
Results
CR was achieved in 24 patients (44%) who received DA, and in 10 patients (28%) with less-intensive therapy. LFS was comparable in both these groups (5 vs 4 months), but superior in patients who received DA. Eight-week early mortality rate was up to 15% after intensive induction therapy and 10% after AZA and LDAC regimens. Nevertheless, median OS in patients treated with DA was marginally superior (5 month) than in patients who received low intensive treatment (4 month) and significantly longer than in patients with BSC (1 month).
Conclusion
The DA regimen remains still a best standard therapy in older AML patients with good performance status and low comorbidity index. Low-intensive treatment strategies (azacitidine, low-dose cytarabine) seem to be good therapeutic options for older patients with severe comorbidities.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Chemotherapy
Abstract: PB1674
Type: Publication Only
Background
Acute myeloid leukemia (AML) is disease of older adults with median age over 65 years. The effect of age and severe comorbidities are associated with high incidence of early death, low rate of complete remission (CR) and poor survival. Treatment options for elderly patients include: intensive chemotherapy, less-intensive regimens, best supportive care as well as enrollment in clinical trials. Therapeutic decisions in older AML patients are highly challenging and need to be individualized since the outcome in this group remains still unsatisfactory.
Aims
The aim of the study was to compare results of different treatment strategies in elderly patients with AML and to analyze overall survival in examined patients.
Methods
Patients. We describe a single center experience of 101 patients (41 females and 60 males) with diagnosis of AML, hospitalized in the Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University between 2007 and 2014. Median age was 70,6 years (range, 60-90 years). In 85 patients AML was diagnosed de novo, whereas 16 patients had secondary AML. Adverse, intermediate and favorable karyotype was found in 14, 82 and 5 patients, respectively. All patients were enrolled into therapeutic procedures according to the age, karyotype, performance status and comorbidity index. Fifty-five patients were treated with intensive chemotherapy regimen based on daunorubicin and cytarabine (DA, “3+ 5-7”), 22 patients obtained azacitidine (AZA), 14 patients were treated with low-dose cytarabine (LDAC), and only 10 patients received best supportive care (BSC). We estimated percent of CR, early mortality rate, leukemia free survival (LFS) and overall survival (OS).
Results
CR was achieved in 24 patients (44%) who received DA, and in 10 patients (28%) with less-intensive therapy. LFS was comparable in both these groups (5 vs 4 months), but superior in patients who received DA. Eight-week early mortality rate was up to 15% after intensive induction therapy and 10% after AZA and LDAC regimens. Nevertheless, median OS in patients treated with DA was marginally superior (5 month) than in patients who received low intensive treatment (4 month) and significantly longer than in patients with BSC (1 month).
Conclusion
The DA regimen remains still a best standard therapy in older AML patients with good performance status and low comorbidity index. Low-intensive treatment strategies (azacitidine, low-dose cytarabine) seem to be good therapeutic options for older patients with severe comorbidities.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Chemotherapy
Type: Publication Only
Background
Acute myeloid leukemia (AML) is disease of older adults with median age over 65 years. The effect of age and severe comorbidities are associated with high incidence of early death, low rate of complete remission (CR) and poor survival. Treatment options for elderly patients include: intensive chemotherapy, less-intensive regimens, best supportive care as well as enrollment in clinical trials. Therapeutic decisions in older AML patients are highly challenging and need to be individualized since the outcome in this group remains still unsatisfactory.
Aims
The aim of the study was to compare results of different treatment strategies in elderly patients with AML and to analyze overall survival in examined patients.
Methods
Patients. We describe a single center experience of 101 patients (41 females and 60 males) with diagnosis of AML, hospitalized in the Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University between 2007 and 2014. Median age was 70,6 years (range, 60-90 years). In 85 patients AML was diagnosed de novo, whereas 16 patients had secondary AML. Adverse, intermediate and favorable karyotype was found in 14, 82 and 5 patients, respectively. All patients were enrolled into therapeutic procedures according to the age, karyotype, performance status and comorbidity index. Fifty-five patients were treated with intensive chemotherapy regimen based on daunorubicin and cytarabine (DA, “3+ 5-7”), 22 patients obtained azacitidine (AZA), 14 patients were treated with low-dose cytarabine (LDAC), and only 10 patients received best supportive care (BSC). We estimated percent of CR, early mortality rate, leukemia free survival (LFS) and overall survival (OS).
Results
CR was achieved in 24 patients (44%) who received DA, and in 10 patients (28%) with less-intensive therapy. LFS was comparable in both these groups (5 vs 4 months), but superior in patients who received DA. Eight-week early mortality rate was up to 15% after intensive induction therapy and 10% after AZA and LDAC regimens. Nevertheless, median OS in patients treated with DA was marginally superior (5 month) than in patients who received low intensive treatment (4 month) and significantly longer than in patients with BSC (1 month).
Conclusion
The DA regimen remains still a best standard therapy in older AML patients with good performance status and low comorbidity index. Low-intensive treatment strategies (azacitidine, low-dose cytarabine) seem to be good therapeutic options for older patients with severe comorbidities.
Session topic: E-poster
Keyword(s): Acute myeloid leukemia, Chemotherapy
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