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Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial

BACKGROUND: Management of unfit AML patients is a therapeutic challenge. Most hematologists tend to avoid aggressive treatment leaving patients with a choice of best supportive care. We hypothesized that metronomic chemotherapy could be an alternative treatment for unfit AML patients. METHODS: A mul...

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Autores principales: Pongudom, Saranya, Phinyo, Phichayut, Chinthammitr, Yingyong, Charoenprasert, Kanyaporn, Kasyanan, Harutaya, Wongyai, Klaijith, Purattanamal, Jittiporn, Panoi, Naiyana, Surawong, Anoree
Formato: Online Artículo Texto
Lenguaje:English
Publicado: West Asia Organization for Cancer Prevention 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294042/
https://www.ncbi.nlm.nih.gov/pubmed/31983177
http://dx.doi.org/10.31557/APJCP.2020.21.1.147
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author Pongudom, Saranya
Phinyo, Phichayut
Chinthammitr, Yingyong
Charoenprasert, Kanyaporn
Kasyanan, Harutaya
Wongyai, Klaijith
Purattanamal, Jittiporn
Panoi, Naiyana
Surawong, Anoree
author_facet Pongudom, Saranya
Phinyo, Phichayut
Chinthammitr, Yingyong
Charoenprasert, Kanyaporn
Kasyanan, Harutaya
Wongyai, Klaijith
Purattanamal, Jittiporn
Panoi, Naiyana
Surawong, Anoree
author_sort Pongudom, Saranya
collection PubMed
description BACKGROUND: Management of unfit AML patients is a therapeutic challenge. Most hematologists tend to avoid aggressive treatment leaving patients with a choice of best supportive care. We hypothesized that metronomic chemotherapy could be an alternative treatment for unfit AML patients. METHODS: A multi-center randomized controlled trial was conducted in seven university-affiliated hospitals in Thailand. Unfit AML patients were recruited and followed up from December 2014 to December 2017. Patients were randomly assigned to receive either metronomic chemotherapy or palliative hydroxyurea. Overall survival rates were compared using Cox’s proportional hazard survival analysis. RESULTS: A total of 81 eligible patients were randomly allocated and included for ITT analysis. The OS rate was higher in group receiving metronomic chemotherapy than in group receiving palliative treatment at 6 and 12 months with borderline significance (6 months HR 0.60; 95%CI 0.36, 1.02; p-value 0.060; 12 months: HR 0.66; 95%CI 0.41, 1.08; p-value 0.097). CONCLUSION: Metronomic chemotherapy could prolong survival time of unfit AML patients, especially in the first 12 months after diagnosis without increasing treatment-associated adverse events.
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spelling pubmed-72940422020-06-29 Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial Pongudom, Saranya Phinyo, Phichayut Chinthammitr, Yingyong Charoenprasert, Kanyaporn Kasyanan, Harutaya Wongyai, Klaijith Purattanamal, Jittiporn Panoi, Naiyana Surawong, Anoree Asian Pac J Cancer Prev Research Article BACKGROUND: Management of unfit AML patients is a therapeutic challenge. Most hematologists tend to avoid aggressive treatment leaving patients with a choice of best supportive care. We hypothesized that metronomic chemotherapy could be an alternative treatment for unfit AML patients. METHODS: A multi-center randomized controlled trial was conducted in seven university-affiliated hospitals in Thailand. Unfit AML patients were recruited and followed up from December 2014 to December 2017. Patients were randomly assigned to receive either metronomic chemotherapy or palliative hydroxyurea. Overall survival rates were compared using Cox’s proportional hazard survival analysis. RESULTS: A total of 81 eligible patients were randomly allocated and included for ITT analysis. The OS rate was higher in group receiving metronomic chemotherapy than in group receiving palliative treatment at 6 and 12 months with borderline significance (6 months HR 0.60; 95%CI 0.36, 1.02; p-value 0.060; 12 months: HR 0.66; 95%CI 0.41, 1.08; p-value 0.097). CONCLUSION: Metronomic chemotherapy could prolong survival time of unfit AML patients, especially in the first 12 months after diagnosis without increasing treatment-associated adverse events. West Asia Organization for Cancer Prevention 2020 /pmc/articles/PMC7294042/ /pubmed/31983177 http://dx.doi.org/10.31557/APJCP.2020.21.1.147 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Pongudom, Saranya
Phinyo, Phichayut
Chinthammitr, Yingyong
Charoenprasert, Kanyaporn
Kasyanan, Harutaya
Wongyai, Klaijith
Purattanamal, Jittiporn
Panoi, Naiyana
Surawong, Anoree
Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title_full Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title_fullStr Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title_full_unstemmed Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title_short Efficacy and Safety of Metronomic Chemotherapy Versus Palliative Hydroxyurea in Unfit Acute Myeloid Leukemia Patients: A Multicenter, Open-Label Randomized Controlled Trial
title_sort efficacy and safety of metronomic chemotherapy versus palliative hydroxyurea in unfit acute myeloid leukemia patients: a multicenter, open-label randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7294042/
https://www.ncbi.nlm.nih.gov/pubmed/31983177
http://dx.doi.org/10.31557/APJCP.2020.21.1.147
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