High-dose cytarabine induction is well tolerated and active in patients with de novo acute myeloid leukemia older than 60 years.

Abstract

BACKGROUND:

High-dose cytarabine (HiDAC) is safe and very effective in younger patients with acute myeloid leukemia (AML), but it generally is not well tolerated in the elderly.

METHODS:

The authors explored the safety and tolerability of a modified HiDAC induction regimen consisting of 6 daily doses of cytarabine at 2 g/m(2) in combination with 3 daily doses of daunorubicin at 45 mg/m(2) in 59 consecutive patients aged >60 years who had de novo AML diagnosed between July 1996 and February 2005.

RESULTS:

The median patient age was 68 years (range, 60-86 years). The regimen was well tolerated. Infections were common and occurred in 39% of patients, but cerebellar toxicities occurred in only 7% of patients and were reversible. The day-30 induction-related mortality rate was 10%. Overall, 69% of patients achieved complete remissions (CR), and 80% received up to 3 consolidations with HiDAC. The median follow-up for surviving patients was 53 months (range, 17-114 months). The median overall survival was 15.3 months (range, 1-114 months), and the relapse-free survival was 13.8 months (range, 1-113 months). Survival for patients who achieved CR was 27 months (range, 2-114 months).

CONCLUSIONS:

The modified HiDAC regimen was well tolerated in patients aged >60 years with AML and was associated with low induction mortality and high rates of CR. Nevertheless, these high remissions still were associated with poor overall outcomes.

• Authors: Martha Arellano, Elliott Winton, Lin Pan, Lisa Lima, Mourad Tighiouart, Kapil Bhalla, Leonard T Heffner, Jessica Neely, Donald Hutcherson, Morgan McLemore, Amelia Langston, H Jean Khoury
• Journal: Cancer (Cancer) Vol. 118 Issue 2 Pg. 428-33 (Jan 15 2012) ISSN: 1097-0142 [Electronic] United States
• PMID: 21717443 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 American Cancer Society.

Chemical References

• Cytarabine

Topics

• Aged
• Aged, 80 and over
• Comorbidity
• Cytarabine (administration & dosage, adverse effects)
• Female
• Humans
• Leukemia, Myeloid, Acute (drug therapy, mortality)
• Male
• Middle Aged
• Remission Induction
• Survival Analysis