Azacitidine for the treatment of patients with acute myeloid leukemia
Azacitidine for the treatment of patients with acute myeloid leukemia
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DOI：
10.1002/cncr.26354
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发表时间：
2012-02-15
期刊：
影响因子：
6.2
通讯作者：
Musto, Pellegrino
中科院分区：
文献类型：
--
作者：
Maurillo, Luca;Venditti, Adriano;Musto, Pellegrino
背景技术背景：阿扎胞苷治疗高危骨髓增生异常综合征的疗效促使其潜在作用的问题，甚至在治疗急性髓细胞白血病（AML）。方法：对82例符合WHO诊断标准的AML患者进行分析。患者的中位年龄为72岁（范围：29-87岁），27例患者（33%）患有继发性AML。在62例具有可评估细胞遗传学的患者中，18例患者（29%）具有低风险核型，44例患者（71%）具有中间核型。35例患者（43%）接受阿扎胞苷作为一线治疗，47例患者（57%）既往接受过一线或一线以上化疗。研究结果：总体缓解率为32%（82例患者中的26例），包括12例（15%）完全缓解（CR），4例（5%）CR伴血细胞计数不完全恢复（CRi），10例（12%）部分缓解（PR）。与预治疗患者相比，未治疗患者中观察到的缓解更频繁;事实上，35例未治疗患者中有17例（48%）缓解，包括11例（31%）归类为CR/CRi的缓解。相反，47例预治疗患者中只有9例（19%）有应答，其中5例应答（11%）被归类为CR/Cri。未接受治疗的患者和有白色血细胞计数的患者的应答率显著较高（P <0.006
BACKGROUND: The efficacy of azacitidine for the treatment of high-risk myelodysplastic syndromes has prompted the issue of its potential role even in the treatment of acute myeloid leukemia (AML). METHODS: The authors analyzed 82 patients with AML who were diagnosed according to World Health Organization criteria. The median patient age was 72 years (range, 29-87 years), and 27 patients (33%) had secondary AML. Of 62 patients with evaluable cytogenetics, 18 patients (29%) had a poor-risk karyotype, and 44 patients (71%) had an intermediate karyotype. Thirty-five patients (43%) received azacitidine as front-line treatment, and 47 patients (57%) had previously received 1 or more line of chemotherapy. RESULTS: The overall response rate was 32% (26 of 82 patients) and included 12 (15%) complete remissions (CRs), 4 (5%) CRs with incomplete blood count recovery (CRi), and 10 (12%) partial responses (PRs). Responses were observed more frequently among untreated patients compared with pretreated patients; in fact, 17 of 35 untreated patients (48%) responded, including 11 responses (31%) classified as CR/CRi. Conversely, only 9 of 47 pretreated patients (19%) responded, including 5 responses (11%) that were classified as CR/Cri. The response rate was significantly higher for untreated patients (P.006) and those who had white blood cell counts