Cargando…
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...
Autores principales: | , , , , , |
---|---|
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 |
_version_ | 1784798201989038080 |
---|---|
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. |
format | Online Article Text |
id | pubmed-9514083 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Kare Publishing |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT karakusvolkan survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata AT maralsenem survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata AT kayaegemen survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata AT gemicialiihsan survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata AT dereyelda survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata AT sevindikomurgokmen survivaloutcomesofhypomethylatingagentsmaintenancetherapyinnewdiagnosedamlpatientsrealexperiencedata |