High Response Rate for Treatment With Gemtuzumab Ozogamicin and Cytarabine in Elderly Patients With Acute Myeloid Leukemia and Favorable and Intermediate-I Cytogenetic Risk

Tavor, Sigal; Rahamim, Einam; Sarid, Nadav; Rozovski, Uri; Gibstein, Lili; Aviv, Freddy; Kirsner, Ilya; Naparstek, Elizabeth

doi:10.1016/j.clml.2012.05.007

Cited by 8 publications

(2 citation statements)

References 16 publications

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“…[23] However, with the availability of newer agents, things are changing. [24,25] Also low-dose cytarabine was not found to be effective in patients with high-risk cytogenetics. [23] Decision about fitness for treatment should not be made on the basis of age alone, but should arise from a comprehensive assessment of the patient as well as the biology of the disease.…”

Section: Discussionmentioning

confidence: 94%

Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review

et al. 2013

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Acute myeloid leukemia (AML) in older adults differs biologically and clinically from that in younger patients and is characterized by adverse chromosomal abnormalities, stronger intrinsic resistance, and lower tolerance to chemotherapy. In patients over age 60 with AML, cure rates are under 10% despite intensive chemotherapy, and most of them die within a year of diagnosis. Over the last decade, metronomic chemotherapy has emerged as a potential strategy to control advanced/refractory cancer. Here, we report a case of a 68-year-old gentleman having AML with high-risk cytogenetic features, who achieved complete remission on our oral metronomic PrET (PrET: Prednisolone, etoposide, thioguanine) protocol on an outpatient basis. He was later treated with standard high-dose (HD) cytosine arabinoside (Ara-C) consolidation followed by maintenance with etoposide, thioguanine, and sodium valproate. Presently, the patient is nearly 35 months since diagnosis and 21 months off treatment. This case report and review highlights that the combination of oral low-intensity metronomic therapy, followed by standard HD consolidation therapy and metronomic maintenance therapy may be well tolerated by elderly patients especially with less proliferative, high (cytogenetic)-risk AML who are otherwise deemed to be unfit for intensive intravenous induction chemotherapy regimens. References for this review were identified through searches of Pubmed for recent publications on the subject as well as searches of the files of the authors themselves. The final list was generated on the basis of originality and relevance to this review.

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Section: Discussionmentioning

confidence: 94%

Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review

et al. 2013

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“…Only 1/3 of the elderly ([60 years) AML patients may receive intensive chemotherapy protocols [1]. The patients who cannot receive intensive chemotherapy are given either only a effective supportive therapy or protocols that contain low doses of cytosine arabinoside (LD-ara-c) [1], azacitidine [2], clofarabine [3], and gemtuzumab ozogamicin [4]. DNA hypermethylation is the most common permanent pathogenetic process observed in MDS and AML patients.…”

Section: Introductionmentioning

confidence: 99%

Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2)

Atalay

Atesoglu

2015

Indian J Hematol Blood Transfus

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Only one-third of elderly ([60 years) AML and MDS-RAEB2 patients may receive intensive chemotherapy treatment alternatives that are limited in this patient group due to the potential of severe toxicity. Previous studies have shown that azacitidine and low dose cytarabine treatments may be a beneficial treatment option for these patients. In this study, we aimed to good results with low toxicity in elderly patients. We retrospectively analyzed the AML and MDS-RAEB2 patients who received azacitidine monotherapy and azacitidine and LDL-ara-c combination therapy for a comparison of their response to therapy, survival rates, and toxicity rates and for determining the factors that could affect their overall survival. A total of 27 patients who were diagnosed with de novo AML and MDS-RAEB2 and who received at least four cycles of chemotherapy were included in the study, and the data were evaluated retrospectively. When monotherapy and combination therapy groups were compared, the pretreatment bone marrow blast count was observed to be greater in the combination therapy group. A statistically significant difference was not detected between the groups regarding the response to therapy ratios (p = 0.161) (42.9 and 57.1 %, respectively). No difference was detected between the groups regarding therapy-related toxicity. Infections were the most common complication.Progression-free survival was 30.3 % for the azacitidine monotherapy group and 66.7 % for the combination (azacitidine ? LD-ara-c) group. The factors influencing the overall survival rate were determined based on the response to the first-line therapies, more than a grade 2 infection, fever, and relapse in a multi-variance analysis. The combination therapy may be a well-tolerated treatment option for the elderly, vulnerable AML patients whose blast count is high in response to therapy rates, overall survival rates, and toxicities are not different, although the pre-treatment bone marrow blast count was greater in the combination therapy groups compared with the monotherapy group.

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Gemtuzumab

Tridente¹

2013

Adverse Events With Biomedicines

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High Response Rate for Treatment With Gemtuzumab Ozogamicin and Cytarabine in Elderly Patients With Acute Myeloid Leukemia and Favorable and Intermediate-I Cytogenetic Risk

Cited by 8 publications

References 16 publications

Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review

Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review

Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2)

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