Decitabine compared to standard treatment in older patients with acute myeloid leukemia

This study aimed to investigate the safety and effectiveness of decitabine in older patients with acute myeloid leukemia. This study concluded that decitabine is safe and effective in these patients. 

The occurrence of acute myeloid leukemia (AML) increases with age. The overall prognosis remains poor for older patients with AML. Decitabine (Dacogen) is a chemotherapy drug used for conditions where blood cells are dysfunctional. It may also be used in the treatment of AML. The results of previous studies of decitabine in older patients have been contradictory. Therefore, it is important to evaluate the outcomes of older patients with AML treated with decitabine in comparison with other chemotherapies.  

This study reviewed data from 38 studies. Overall were involved 3298 patients over the age of 60 with AML. Complete response (CR) and overall response (OR) were measured to indicate the effectiveness of treatments in older patients with AML. Decitabine treatment was compared to other standard chemotherapy drugs for AML.   

Patients who received decitabine had a 2.6 times higher chance of CR compared to those who received low-dose cytarabine (Cytosar-U). Patients who received decitabine also had 4.88 times higher chance for an OR compared to those who received cytarabine.

Patients in the decitabine group had a 2.53 times higher chance for a CR and a 2.89 time higher chance for an OR compared to those who received the CAG/HAG regimen. CAG involves low-dose epirubicin (Ellence) and cytarabine with granulocyte-colony stimulating factor (G-CSF or Filgrastim). HAG involves low-dose homoharringtonine (Synribo) and cytarabine with G-CSF.   

Patients who received decitabine had a CR rate equivalent to those who received intensive chemotherapy (such as cytarabine plus anthracycline). Patients who received decitabine in combination with other regimens had higher CR/OR rates when compared to patients who received decitabine alone. 

This study concluded that decitabine is safe and effective in older patients with AML.