In a nutshell
This study aimed to compare frontline therapies in older patients with acute myeloid leukemia.
This study concluded that hypomethylating agents provided better overall survival for these patients.
Some background
Older patients with acute myeloid leukemia (AML), more frequently experience therapy-resistant disease. They also commonly have comorbidities. These can lead to poor overall survival (OS) and therapeutic challenges. A comorbidity is the presence of one or more conditions co-occurring with a primary condition.
Daunorubicin (Cerubidine) and cytarabine (Cytosar) are chemotherapies for AML. Hypomethylating agents (HMA) are drugs that interfere with the DNA in cancer cells. They prevent the growth of these cells. Supportive care therapy (SC) is care given to improve the quality of life of patients who have a serious or life-threatening disease. All of these therapies are frontline therapies for older patients with AML.
The optimal frontline therapies for these patients are still unknown.
Methods & findings
This study involved 980 patients aged 70 and older who had AML. Survival outcomes were measured. Patients were split into four treatment groups. 36.7% of patients received high-intensity (daunorubicin/cytarabine or equivalent) treatment (HI group). 9.3% of patients received low-intensity (low-dose cytarabine or similar without hypomethylating agents) treatment (LI group). 26% of the patients received hypomethylating agents (HMA group). 28% of the patients received supportive care therapy (SC group).
The average overall survival (OS) for all patients was 7.1 months after a period of 20.5 months. Secondary AML, performance status, frontline therapy, age, blood cell count at diagnosis had an impact on survival.
The HMA group had OS time of 14.4 months compared to 10.8 months for the HI group, 5.9 months for the LI group and 2.1 months for the SC group.
The bottom line
This study concluded that HMAs provided better OS for older patients with AML. It was also concluded that HI treatment provided better OS when compared to LI and SC treatment.
The fine print
This study was based on medical records. Some data might have been missing. This may affect the results.
Published By :
Haematologica
Date :
May 09, 2019
