RT Journal Article
T1 Hypomethylating agents in relapsed and refractory AML: outcomes and their predictors in a large international patient cohort.
A1 Stahl, Maximilian
A1 DeVeaux, Michelle
A1 Montesinos, Pau
A1 Itzykson, Raphael
A1 Ritchie, Ellen K
A1 Sekeres, Mikkael A
A1 Barnard, John D
A1 Podoltsev, Nikolai A
A1 Brunner, Andrew M
A1 Komrokji, Rami S
A1 Bhatt, Vijaya R
A1 Al-Kali, Aref
A1 Cluzeau, Thomas
A1 Santini, Valeria
A1 Fathi, Amir T
A1 Roboz, Gail J
A1 Fenaux, Pierre
A1 Litzow, Mark R
A1 Perreault, Sarah
A1 Kim, Tae Kon
A1 Prebet, Thomas
A1 Vey, Norbert
A1 Verma, Vivek
A1 Germing, Ulrich
A1 Bergua, Juan Miguel
A1 Serrano, Josefina
A1 Gore, Steven D
A1 Zeidan, Amer M
K1 Myeloid Neoplasia
K1 Clinical Trials and Observations
K1 Antimetabolitos antineoplásicos
AB Although hypomethylating agents (HMAs) are frequently used in the frontline treatment of older acute myeloid leukemia (AML) patients, little is known about their effectiveness in relapsed or primary treatment-refractory (RR)-AML. Using an international multicenter retrospective database, we studied the effectiveness of HMAs in RR-AML and evaluated for predictors of response and overall survival (OS). A total of 655 patients from 12 centers received azacitidine (57%) or decitabine (43%), including 290 refractory (44%) and 365 relapsed (56%) patients. Median age at diagnosis was 65 years. Best response to HMAs was complete remission (CR; 11%) or CR with incomplete count recovery (CRi; 5.3%). Additionally, 8.5% experienced hematologic improvement. Median OS was 6.7 months (95% confidence interval, 6.1-7.3). As expected, OS differed significantly by best response, with patients achieving CR and CRi having a median OS of 25.3 and 14.6 months, respectively. In multivariate analysis, the presence of ≤5% circulating blasts and a 10-day schedule of decitabine were associated with improved response rates, whereas the presence of >5% circulating blasts and >20% bone marrow blasts were associated with decreased OS. A significant subset of RR-AML patients (16%) achieved CR/CRi with HMAs and experienced a median OS of 21 months. Outside of a clinical trial, HMAs represent a reasonable therapeutic option for some patients with RR-AML.
PB American Society of Hematology
YR 2018
FD 2018-03-13
LK http://hdl.handle.net/10668/12380
UL http://hdl.handle.net/10668/12380
LA en
NO Stahl M, DeVeaux M, Montesinos P, Itzykson R, Ritchie EK, Sekeres MA, et al. Hypomethylating agents in relapsed and refractory AML: outcomes and their predictors in a large international patient cohort. Blood Adv. 2018 Apr 24;2(8):923-932.
DS RISalud
RD Apr 7, 2025