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Long-term survival after intensive chemotherapy or hypomethylating agents in AML patients aged 70 years and older: a large patient data set study from European registries.

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Date

2021-09-13

Authors

Recher, Christian
Röllig, Christoph
Berard, Emilie
Bertoli, Sarah
Dumas, Pierre-Yves
Tavitian, Suzanne
Kramer, Michael
Serve, Hubert
Bornhäuser, Martin
Platzbecker, Uwe

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Nature Publishing Group
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Abstract

The outcome of acute myeloid leukemia patients aged 70 years or older is poor. Defining the best treatment option remains controversial especially when choosing between intensive chemotherapy and hypomethylating agents. We set up a multicentric European database collecting data of 3 700 newly diagnosed acute myeloid leukemia patients ≥70 years. The primary objective was to compare overall survival in patients selected for intensive chemotherapy (n = 1199) or hypomethylating agents (n = 1073). With a median follow-up of 49.5 months, the median overall survival was 10.9 (95% CI: 9.7-11.6) and 9.2 months (95% CI: 8.3-10.2) with chemotherapy and hypomethylating agents, respectively. Complete remission or complete remission with incomplete hematologic recovery was 56.1% and 19.7% with chemotherapy and hypomethylating agents, respectively (P < 0.0001). Treatment effect on overall survival was time-dependent. The Royston and Parmar model showed that patients treated with hypomethylating agents had a significantly lower risk of death before 1.5 months of follow-up; no significant difference between 1.5 and 4.0 months, whereas patients treated with intensive chemotherapy had a significantly better overall survival from four months after start of therapy. This study shows that intensive chemotherapy remains a valuable option associated with a better long-term survival in older AML patients.

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Aged
Aged, 80 and over
Antineoplastic combined chemotherapy protocols
Azacitidine
Humans
Registries

DeCS Terms

Anciano
Azacitidina
Leucemia mieloide aguda
Protocolos de quimioterapia combinada antineoplásica
Resultado del tratamiento
Sistema de registros

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Keywords

Leukemia, myeloid, acute, Registries, Treatment outcome

Citation

Récher C, Röllig C, Bérard E, Bertoli S, Dumas PY, Tavitian S, et al. Long-term survival after intensive chemotherapy or hypomethylating agents in AML patients aged 70 years and older: a large patient data set study from European registries. Leukemia. 2022 Apr;36(4):913-922