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Treatment of elderly patients with acute myeloid leukemia with azacitidine results in fewer hospitalization days and infective complications but similar survival compared with intensive chemotherapy
Author(s) -
Lao Zhentang,
Yiu Richard,
Wong Gee Chuan,
Ho Aloysius
Publication year - 2015
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12331
Subject(s) - azacitidine , myeloid leukemia , medicine , chemotherapy , oncology , biology , biochemistry , gene expression , gene , dna methylation
Abstract Aims Azacitidine has been shown to prolong overall survival (OS) compared with best supportive care in elderly patients with acute myeloid leukemia ( AML ) with low blast counts but it is unknown if azacitidine has a similar efficacy in patients with blast counts of >30%. It is also unknown if azacitidine is comparable to intensive chemotherapy in terms of survival and morbidity. Methods Differences between the outcomes of elderly AML patients who received intensive chemotherapy, azacitidine‐based therapy or best supportive care are studied in this retrospective review. Patients 60 years or older diagnosed with AML between J anuary 2009 and J une 2011 were included. Those who passed away within less than 2 weeks of diagnosis were excluded. Results A t a median follow‐up of 7.2 months (range: 0.5–26.4 months), estimated median OS for patients who received azacitidine‐based therapy was 9.8 months (range: 2.4–22.5 months) compared with 8.9 months (range: 0.9–26.4 months) for patients who received intensive chemotherapy ( P = 0.89). Compared with azacitidine‐based therapy, intensive chemotherapy is associated with more inpatient days and episodes of febrile illness requiring inpatient stay or intravenous antibiotics. Conclusions Compared with intensive chemotherapy in elderly patients with AML , azacitidine‐based therapy is associated with similar median survival but lower number of hospitalization days and infective episodes.