Abstract:
:Intensive induction chemotherapy using anthracycline and cytarabine backbone is considered the most effective upfront therapy in physically fit older patients with acute myeloid leukemia (AML). However, outcomes of the standard induction in elderly AML are inferior to those observed in younger patients, and they are still unsatisfactory. As addition of cladribine to the standard induction therapy is known to improve outcome in younger AML patients. The present randomized phase II study compares efficacy and toxicity of the DAC (daunorubicin plus cytarabine plus cladribine) regimen with the standard DA (daunorubicin plus cytarabine) regimen in the newly diagnosed AML patients over 60 years of age. A total of 171 patients were enrolled in the study (DA, 86; DAC, 85). A trend toward higher complete remission (CR) was observed in the DAC arm compared to the DA arm (44% vs. 34%; P = .19), which did not lead to improved median overall survival, which in the case of the DAC group was 8.6 months compared to in 9.1 months in the DA group (P = .64). However, DAC appeared to be superior in the group of patients aged 60-65 (CR rate: DAC 51% vs. DA 29%; P = .02). What is more, a subgroup of patients, with good and intermediate karyotypes, benefited from addition of cladribine also in terms of overall survival (P = .02). No differences in hematological and nonhematological toxicity between the DA and DAC regimens were observed.
journal_name
Am J Hematoljournal_title
American journal of hematologyauthors
Pluta A,Robak T,Wrzesien-Kus A,Katarzyna Budziszewska B,Sulek K,Wawrzyniak E,Czemerska M,Zwolinska M,Golos A,Holowiecka-Goral A,Kyrcz-Krzemien S,Piszcz J,Kloczko J,Mordak-Domagala M,Lange A,Razny M,Madry K,Wiktor-Jedrzedoi
10.1002/ajh.24654subject
Has Abstractpub_date
2017-04-01 00:00:00pages
359-366issue
4eissn
0361-8609issn
1096-8652journal_volume
92pub_type
杂志文章,随机对照试验abstract::Ten previously untreated elderly patients with hypocellular acute leukemia received a low dose of cytosine arabinoside (Ara-C), 10 mg/m2 injected subcutaneously every 12 hours for 14-28 days. Six patients achieved a complete remission (CR) for periods ranging for 6-23 months (median 8.5 months) and the others had a pa...
journal_title:American journal of hematology
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abstract::Morbid obesity is a health problem that has been shown to be refractory to diet, exercise, and medical treatment. Surgeries designed to promote weight loss, termed bariatric surgery and typically involving a gastric bypass procedure, have recently been implemented to treat obesity with high success rates. However, lon...
journal_title:American journal of hematology
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