Original Articles
Vol. 8 (2016): Review, Original Articles, Case Reports
https://doi.org/10.4084/mjhid.2016.009

TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE

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Received: August 14, 2015
Accepted: November 26, 2015
Published: January 1, 2016
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acute myeloid leukemia, low-dose cytarabine, treatment, elderly, prognosis.
Hematology

Authors

Maël Heiblig
Lyon-Sud Hospital France, .
Mohamed Elhamri
Lyon-Sud Hospital France, .
Isabelle Tigaud
Lyon-Sud Hospital France, .
Adriana Plesa
Lyon-Sud Hospital France, .
Fiorenza Barraco
Lyon-Sud Hospital France, .
Hélène Labussière
Lyon-Sud Hospital France, .
Sophie Ducastelle
Lyon-Sud Hospital France, .
Mauricette Michallet
Lyon-Sud Hospital France, .
Franck Nicolini
Lyon-Sud Hospital France, .
Claudiu Plesa
Clinique Mutualiste Lyon France, .
Eric Wattel
Lyon-Sud Hospital France, .
Gilles Salles
Lyon-Sud Hospital France, .
Xavier Thomas
xavier.thomas@chu-lyon.fr
Lyon-Sud Hospital France, France.

Objectives: Low-dose cytarabine (LD-AraC) is still regarded as the standard of care in elderly patients with acute myeloid leukemia (AML) ‘unfit’ for intensive chemotherapy. In this study, we compared the efficacy of LD-AraC, in patients ? 70 years old, with that of intensive chemotherapy, best supportive care (BSC), or hypomethylating agents in a single institution experience.

Methods: Between 2000 and 2014, 60 patients received LD-AraC at 20 mg once or twice daily by subcutaneous injection for 10 consecutive days every 4-6 weeks. 85 patients were treated by intensive chemotherapy, 34 patients by hypomethylating agents, and 43 patients only by BSC.

Results: Complete remission rate with LD-AraC was 7% versus 56% with intensive chemotherapy and 21% with hypomethylating agents. Median overall survival (OS) of patients treated with LD-AraC was 9.6 months with 3-year OS of 12%. Survival with LD-AraC was better than with BSC only (P = 0.001). Although not statistically significant, intensive chemotherapy and hypomethylating agents tended to be better than LD-AraC in terms of OS (median: 12.4 months and 16.1 months, respectively). There was no clear evidence that a beneficial effect of LD-AraC was restricted to any particular subtype of patients, except for cytogenetics.

Conclusions: Despite a trend in favor of intensive chemotherapy and hypomethylating agents over LD-AraC, no real significant advantage could be demonstrated, while LD-AraC showed a significant advantage comparatively to BSC. This tends to confirm that LD-AraC can still represent a baseline against which new promising agents may be compared either alone or in combination.

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Original Article

Supporting Agencies

Hospices Civils de Lyon, Hematology, Lyon-Sud Hospital, France

How to Cite



“TREATMENT WITH LOW-DOSE CYTARABINE IN ELDERLY PATIENTS (AGE 70 YEARS OR OLDER) WITH ACUTE MYELOID LEUKEMIA: A SINGLE INSTITUTION EXPERIENCE” (2016) Mediterranean Journal of Hematology and Infectious Diseases, 8, p. e2016009. doi:10.4084/mjhid.2016.009.