5‐Azacytidine treatment for relapsed or refractory acute myeloid leukemia after intensive chemotherapy. Issue 7 (30th May 2013)

• Record Type: Journal Article
• Authors: Ivanoff, Sarah; Gruson, Berengere; Chantepie, Sylvain P.; Lemasle, Emilie; Merlusca, Lavinia; Harrivel, Veronique; Charbonnier, Amandine; Votte, Patrick; Royer, Bruno; Marolleau, Jean‐Pierre
• Is Part Of: American journal of hematology. Volume 88:Issue 7(2013:Jul.)
• Page Start: 601
• Page End: 605
• Publication Date: 2013-05-30
• Subjects: Hematology -- Periodicals; 616.15
• DOI: 10.1002/ajh.23464
• Languages: English
• ISSNs: 0361-8609

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Despite progress in the understanding of leukemia pathophysiology, the treatment of acute myeloid leukemia (AML) remains challenging. In patients with refractory or relapsed (R/R) AML, the prognosis is still poor and this group is targeted for new drug development. We reviewed the outcome of 47 patients, with R/R AML after at least one course of intensive chemotherapy, treated with 5‐azacytidine in three different French institutions. The overall response rate was 38% including complete remission in 21%, partial remission in 11%, and hematological improvement in 6% of cases. Median time to relapse was 6 (range, 1–39) months. Median overall survival was 9 months (not reached by responders vs. 4.5 months for nonresponders patients, <italic>P</italic> = 0.0001). Univariate analysis identified the absence of peripheral blood blasts and <20% bone marrow blasts as prognostic factors for both overall response and survival, but not age, ECOG/PS, type of AML, cytogenetic, status of the disease, number of previous lines of therapy, previous hematological stem cell transplantation, or white blood cells count. Bone marrow blasts percentage <20% was the only independent prognostic factor identified by multivariate analysis for overall response (<italic>P</italic> = 0.0013) and survival (<italic>P</italic> = 0.0324). Six patients in remission could proceed to an allogenic hematological stem cell transplantation. The drug‐related grade 3/4 adverse events were hematopoietic toxicities (38%) and infection (32%). In conclusion, this study suggests that a salvage therapy with 5‐azacytidine is an interesting option for patients with R/R AML after intensive chemotherapy. Prospective randomized studies are needed to demonstrate a superiority of this approach over others strategies. Am. J. Hematol. 88:601–605, 2013. © 2013 Wiley Periodicals, Inc.</p> </abstract>