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Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data

OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients...

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Autores principales: Karakus, Volkan, Maral, Senem, Kaya, Egemen, Gemici, Aliihsan, Dere, Yelda, Sevindik, Omur Gokmen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9514083/
https://www.ncbi.nlm.nih.gov/pubmed/36276561
http://dx.doi.org/10.14744/nci.2021.42800
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author Karakus, Volkan
Maral, Senem
Kaya, Egemen
Gemici, Aliihsan
Dere, Yelda
Sevindik, Omur Gokmen
author_facet Karakus, Volkan
Maral, Senem
Kaya, Egemen
Gemici, Aliihsan
Dere, Yelda
Sevindik, Omur Gokmen
author_sort Karakus, Volkan
collection PubMed
description OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data. METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups. RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1–14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2–17 months) in maintenance and 3 months (1–13 months) in non-maintenance groups (p=0.001). CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA.
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spelling pubmed-95140832022-10-21 Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data Karakus, Volkan Maral, Senem Kaya, Egemen Gemici, Aliihsan Dere, Yelda Sevindik, Omur Gokmen North Clin Istanb Original Article OBJECTIVE: Acute myeloid leukemia (AML) is a hematological malignancy that frequently affects elderly population. With introducing the hypomethylating agents (HMAs) in elderly AML treatment, survival rates and quality of life have improved. However, long-term management in elderly and frail patients is still a challenge. In the present study, we aimed to determine whether HMA maintenance therapy is required until disease progression in frail and elderly AML patients by examining with a real-life data. METHODS: In a multicenter study, we analyzed non-promyelocytic elderly AML patients who were treated with first-line azacitidine or decitabine monotherapy in two different groups, retrospectively. While patients were treated with HMA until progression in the maintenance group, 6+3 cycles of azacitidine or decitabine were administered as a standard care of elderly AML patients in the non-maintenance group. Survival outcomes were compared between the groups. RESULTS: HMA therapy was maintained until progression in 20 patients, and HMA therapy was terminated after 6+3 cycles in 21 patients. Patients received a median of 6 (1–14) HMA cycles during follow-up time. The median 7.5 months of overall survival were observed (2–17 months) in maintenance and 3 months (1–13 months) in non-maintenance groups (p=0.001). CONCLUSION: Despite long-term exposure to HMA may appear as a risk factor for complications and toxicities in elderly and frail AML patients, the maintenance of therapy until disease progression provides a significant survival advantage. Therefore, we suggest that HMA therapy should continue until disease progression regardless the sort of HMA. Kare Publishing 2022-08-31 /pmc/articles/PMC9514083/ /pubmed/36276561 http://dx.doi.org/10.14744/nci.2021.42800 Text en © Copyright 2022 by Istanbul Provincial Directorate of Health https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle Original Article
Karakus, Volkan
Maral, Senem
Kaya, Egemen
Gemici, Aliihsan
Dere, Yelda
Sevindik, Omur Gokmen
Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title_full Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title_fullStr Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title_full_unstemmed Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title_short Survival outcomes of hypomethylating agents maintenance therapy in new diagnosed AML patients: Real experience data
title_sort survival outcomes of hypomethylating agents maintenance therapy in new diagnosed aml patients: real experience data
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9514083/
https://www.ncbi.nlm.nih.gov/pubmed/36276561
http://dx.doi.org/10.14744/nci.2021.42800
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