In a nutshell
This study aimed to investigate the combination of low-dose decitabine, medium-dose cytarabine and umbilical cord blood infusion as a consolidation therapy for elderly patients with acute myeloid leukemia.
This study concluded that this treatment combination was effective in these patients.
Some background
Treatment of elderly patients with acute myeloid leukemia (AML) remains difficult. Different treatment combinations are often used for these patients for optimal results. Decitabine (Dacogen) is a chemotherapy for patients with AML who do not respond to normal chemotherapy treatment. Cytarabine (Cytosar-U) is a chemotherapy for AML. Umbilical cord blood (UCB) infusion involves the transfer of blood from the umbilical cord. This blood is rich in stem cells.
Consolidation therapy is used to kill any cancer cells that may be left in the body after the initial treatment. It was not known if consolidation therapy with low-dose decitabine (LD-DAC), medium-dose cytarabine (MD-C), and UCB infusion is a good option for elderly patients with AML.
Methods & findings
This study involved 25 patients aged 60 to 74 who had complete remission (CR) after induction chemotherapy. Patients received LD-DAC), MD-C followed by UCB infusion. Patients were followed up for at least 2 years.
The 2-year overall survival (OS) rate was 68%. The leukemia-free survival (LFS) rate was 60%. 10 patients had a relapse after an average of 16.5 months.
The hematological (blood-related) and non-hematological side effects were mild to moderate. One patient died in remission due to infection with possible acute graft versus host disease (aGVHD). aGVHD is a complication of stem cell transplant where the UCB attacks the patient.
When the patients in this study were compared to a group that had standard consolidation therapy, the group in this study had improved OS and LFS. Side effects were similar between the group who received the LD-DAC, MD-C and UCB and those who received the standard consolidation therapy.
The bottom line
This study concluded that the combination of LD-DAC, MD-C, and UCB may be an optimal consolidation therapy for elderly patients with AML.
The fine print
This was a very small phase 2 study. Larger studies are needed for stronger evidence.
Published By :
BMC cancer
Date :
Aug 20, 2019
