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Elderly do benefit from induction chemotherapy: High dose mitoxantrone‐based (“5 + 1”) induction chemotherapy regimen in newly diagnosed acute myeloid leukemia
Author(s) -
Saini Neeraj Y.,
Cerny Jan,
Furtado Vanessa F.,
Desmond Angela,
Zhou Zheng,
Raffel Glen,
Puthawala Imran,
Bednarik Jayde,
Shanahan Lindsey,
Miron Patricia M.,
Woda Bruce,
Ramanathan Muthalagu,
Nath Rajneesh
Publication year - 2019
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25347
Subject(s) - medicine , mitoxantrone , cytarabine , regimen , myeloid leukemia , induction chemotherapy , chemotherapy , gastroenterology , surgery , chemotherapy regimen , leukemia
An intensive “5 + 1” regimen, which included bolus high dose cytarabine (HiDAC) at 3 g/m 2 once daily over 3 hours on days 1‐5 and high dose mitoxantrone (HDM) 80 mg/m 2 on day 2, was evaluated in 101 consecutively treated newly diagnosed acute myeloid leukemia (AML) patients at a single center since 2009. The median age was 65 (range 18‐90) years. The 4 and 8‐week mortality in our cohort was 3/101 (2.9%) and 7/99 (7%), respectively. The overall response (complete remission [CR] + CRi) was 76.2% (77/101). The median overall survival (OS) stratified by age group <60, 60‐69 and ≥70 years were 56, 31 and 9 months respectively (log‐rank, P = 0.02). 51.7% (45/84) of patients with intermediate/adverse risk category proceeded to allogeneic stem cell transplants. Among these 84 patients, the percentage of patients able to proceed to transplant in age groups <60, 60‐69, and ≥ 70 years were 75% (18/24), 60.7% (17/28), and 31.2% (10/32), respectively. In conclusion, HDM‐based chemotherapy regimen produces high CR rates, is well tolerated and more patients can undergo curative postremission therapy including stem cell transplant.