A favorable inductive remission rate for decitabine combined with chemotherapy as a first course in <60-year-old acute myeloid leukemia patients with myelodysplasia syndrome features.
Adolescent
Adult
Age Factors
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Biomarkers
Decitabine
/ administration & dosage
Diagnosis, Differential
Disease Management
Disease Susceptibility
Female
Follow-Up Studies
Humans
Induction Chemotherapy
Leukemia, Myeloid, Acute
/ diagnosis
Male
Middle Aged
Myelodysplastic Syndromes
/ diagnosis
Prognosis
Propensity Score
Retreatment
Retrospective Studies
Treatment Outcome
Young Adult
MDS features
acute myeloid leukemia
chemotherapy
complete remission
decitabine
induction therapy
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
29
11
2018
revised:
01
06
2019
accepted:
29
06
2019
pubmed:
20
7
2019
medline:
4
9
2020
entrez:
20
7
2019
Statut:
ppublish
Résumé
In acute myeloid leukemia (AML), myelodysplasia-related changes contribute to a poor prognosis. This retrospective, propensity score-matched study analyzed 108 newly diagnosed AML patients with features of myelodysplasia syndrome (MDS) (aged 14-60 years) from 2014 to 2018, who received either idarubicin and cytarabine (IA) or decitabine, idarubicin and cytarabine (DAC+IA), and compared efficacy and toxicity between the two regimens. After propensity score matching, there were 54 patients in each group. The rate of complete remission (CR) was higher in the DAC+IA group than in the IA group (85.2% vs 68.5%, P = .040) after the first course, and toxicities were comparable in both groups. Multivariate analysis indicated that the combination with DAC was independent factor for CR rate after the first induction therapy (OR = 2.978, 95% CI:1.090-8.137, P = .033). Subgroup analysis showed a CR advantage for DAC+IA (vs IA) for patients of intermediate-high risk status according to National Comprehensive Cancer Network prognostic stratification. In conclusion, DAC+IA is therefore offered as a new induction choice for newly diagnosed AML patients with features of MDS, aged <60 years old, especially in intermediate-high risk status.
Identifiants
pubmed: 31322840
doi: 10.1002/cam4.2418
pmc: PMC6718585
doi:
Substances chimiques
Biomarkers
0
Decitabine
776B62CQ27
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5108-5115Subventions
Organisme : Natural Science Foundation of Guangdong
ID : 2016A030313197
Organisme : Clinical Medical Research 5010 Program of Sun Yat-sen University
ID : 2017005
Organisme : Science and Technology Planning Project of Guangdong Province
ID : 2017A020215105
Informations de copyright
© 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Références
Leuk Res. 2007 Oct;31(10):1383-8
pubmed: 17420048
Oncotarget. 2015 Oct 20;6(32):33612-22
pubmed: 26384351
Blood. 2009 Feb 26;113(9):1906-8
pubmed: 19131546
Zhonghua Xue Ye Xue Za Zhi. 2009 May;30(5):313-7
pubmed: 19799126
Blood. 2016 May 19;127(20):2391-405
pubmed: 27069254
Cancer Med. 2019 Sep;8(11):5108-5115
pubmed: 31322840
Oncotarget. 2015 Apr 10;6(10):8388-96
pubmed: 25860933
Am J Hematol. 2014 Sep;89(9):874-81
pubmed: 24861848
Blood. 2009 Jul 30;114(5):937-51
pubmed: 19357394
J Clin Oncol. 2014 Jan 20;32(3):219-28
pubmed: 24297940
Leukemia. 2012 May;26(5):1106-7
pubmed: 22124213
J Transl Med. 2014 Jun 12;12:167
pubmed: 24923330
Leuk Res. 2014 Apr;38(4):443-6
pubmed: 24439565
Blood. 2014 Oct 23;124(17):2705-12
pubmed: 25224413
Clin Epigenetics. 2016 Jun 14;8:68
pubmed: 27307795
Leuk Res. 2016 May;44:17-24
pubmed: 26991610
Br J Haematol. 2002 Oct;119(1):87-96
pubmed: 12358907
Leuk Lymphoma. 2016;57(6):1311-8
pubmed: 26372888
Blood. 2011 Aug 11;118(6):1472-80
pubmed: 21613261
Acta Haematol. 2015;133(2):183-92
pubmed: 25323649
J Natl Compr Canc Netw. 2017 Jul;15(7):926-957
pubmed: 28687581
Blood. 2017 Jan 26;129(4):424-447
pubmed: 27895058