Clofarabine plus low-dose cytarabine followed by clofarabine plus low-dose cytarabine alternating with decitabine in acute myeloid leukemia frontline therapy for older patients.
Clofarabine plus low-dose cytarabine followed by clofarabine plus low-dose cytarabine alternating with decitabine in acute myeloid leukemia frontline therapy for older patients.
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DOI：
10.1002/cncr.27429
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发表时间：
2012-09-15
期刊：
影响因子：
6.2
通讯作者：
Kantarjian HM
中科院分区：
文献类型：
--
作者：
Faderl S;Ravandi F;Huang X;Wang X;Jabbour E;Garcia-Manero G;Kadia T;Ferrajoli A;Konopleva M;Borthakur G;Burger J;Feliu J;Kantarjian HM
老年AML患者的标准治疗效果不佳。我们设计了氯法拉滨加低剂量阿糖胞苷的组合，随后是长时间的巩固与地西他滨交替。60例中位年龄为70岁（范围60-81岁）的新诊断AML患者被纳入研究。给予氯法拉滨20mg/m2静脉滴注，每日× 5天，加阿糖胞苷20mg皮下注射，每日2次，每日× 10天。有反应的患者继续接受包括地西他滨在内的17个疗程的巩固治疗。59例可评估患者中有40例（66%）有反应。完全缓解率为58%。中位无复发生存期（RFS）为14.1个月（95% CI: 6.9-不可估计），中位总生存期（OS）为12.7个月（95% CI: 8.8-不可估计）。应答患者的中位生存期（CR/CRp）为24.2个月（95% CI: 17-不可估计）。与历史上接受氯法拉滨加低剂量阿糖胞苷治疗且巩固时间较短的患者组相比，RFS无统计学差异。诱导死亡率低（8周时为7%），毒性可控。氯法拉滨加低剂量阿糖胞苷与地西他滨交替巩固治疗对新诊断的老年AML患者有效。长期整合的好处仍未得到证实。
Standard therapy for older patients with AML has a poor outcome. We have designed a combination of clofarabine plus low-dose cytarabine followed by a prolonged consolidation alternating with decitabine. Sixty patients with a median age of 70 years (range 60-81) with newly diagnosed AML were included. They received clofarabine 20mg/m2 intravenously daily × 5 days plus cytarabine 20mg subcutaneously twice daily × 10 days. Responding patients continued for up to 17 courses of consolidation therapy including decitabine. Forty of 59 evaluable patients responded (66%). Complete remission rate was 58%. Median relapse-free survival (RFS) was 14.1 (95% CI: 6.9-not estimable) and median overall survival (OS) 12.7 months (95% CI: 8.8-not estimable). Median OS of responding patients (CR/CRp) was 24.2 months (95% CI: 17-not estimable). Compared to a historical group of patients who received clofarabine plus low-dose cytarabine with a shorter consolidation, RFS was not statistically different. Induction mortality was low (7% at 8 weeks) and toxicities manageable. Clofarabine plus low-dose cytarabine alternating with decitabine in consolidation is active in older patients with newly diagnosed AML. The benefits of a prolonged consolidation remain unproven.
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DOI：
10.3324/haematol.13309
发表时间：
2008-12-01
期刊：
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL
影响因子：
--
作者：
Malfuson, Jean-Valere;Etienne, Anne;Dombret, Herve
通讯作者：
Dombret, Herve
影响因子：
6.2
作者：
Kantarjian, H;O'Brien, S;Estey, E
通讯作者：
Estey, E
影响因子：
20.3
作者：
Faderl, Stefan;Ravandi, Farhad;Kantarjian, Hagop M.
通讯作者：
Kantarjian, Hagop M.
影响因子：
3.7
作者：
KAPLAN, EL;MEIER, P
通讯作者：
MEIER, P
影响因子：
168.9
作者：
Krug, Utz;Roellig, Christoph;Mueller-Tidow, Carsten
通讯作者：
Mueller-Tidow, Carsten