Amsacrine-based induction therapy in AML patients with cardiac comorbidities: a retrospective single-center analysis.
AML
Acute myeloid leukemia
Amsacrine
Cardiac comorbidities
Induction therapy
Journal
Annals of hematology
ISSN: 1432-0584
Titre abrégé: Ann Hematol
Pays: Germany
ID NLM: 9107334
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
received:
29
10
2022
accepted:
24
01
2023
pubmed:
8
2
2023
medline:
14
3
2023
entrez:
7
2
2023
Statut:
ppublish
Résumé
Intensive chemotherapy is the backbone of induction treatment in patients with acute myeloid leukemia (AML). However, AML patients with concomitant cardiac disease may not be eligible for anthracycline-based therapies. In a small cohort of patients, we have previously shown that anthracycline-free, amsacrine-based chemotherapy TAA (thioguanine, cytarabine, amsacrine) may be as effective as cytarabine/daunorubicin for induction therapy in these patients. In this systematic retrospective single-center analysis, we documented the outcome of 31 patients with significant cardiac comorbidities including coronary heart disease or cardiomyopathy receiving TAA as induction chemotherapy. Median (range) ejection fraction (EF) was 48% (30-67%) in this cohort. Patients with EF below 30% were considered unfit for intensive induction therapy. Event-free survival (EFS), overall survival (OS), and relapse-free survival (RFS) were 1.61, 5.46, and 13.6 months respectively. Poor outcome was primarily related to a high early mortality rate within the first 30 days of therapy, mainly caused by infectious complications. TAA cannot be recommended as a substitute of standard induction for AML patients with significant concomitant cardiac disease. In the era of novel agents, alternative strategies (e.g., hypomethylating agents plus venetoclax) should be considered when anthracycline-based regimens are not suitable.
Identifiants
pubmed: 36749402
doi: 10.1007/s00277-023-05111-x
pii: 10.1007/s00277-023-05111-x
pmc: PMC9998561
doi:
Substances chimiques
Amsacrine
00DPD30SOY
Anthracyclines
0
Cytarabine
04079A1RDZ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
755-760Subventions
Organisme : Deutsche Forschungsgemeinschaft
ID : 413490537
Informations de copyright
© 2023. The Author(s).
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