Second line azacitidine for elderly or infirmed patients with acute myeloid leukemia (AML) not eligible for allogeneic hematopoietic cell transplantation—a retrospective national multicenter study

Ron Ram*, Moshe Gatt, Drorit Merkel, Ilana Helman, Tsofia Inbar, Arnon Nagler, Irit Avivi, Yishai Ofran

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Elderly and infirm patients with acute myeloid leukemia (AML) with either induction refractory or relapse disease may benefit from treatment with azacitidine. We retrospectively reviewed the data from five tertiary centers in Israel, treated between 2009 and 2015. Thirty-four patients (median age 74 years) were identified. Sixty-two percent of the patients had relapsed disease and 38% had refractory disease. Median time of follow-up was 12.1 months. Out of a total of 327 courses, incidence of infectious episodes was 6%. Eighteen percent experienced major bleeding. Thirty-two percent of the patients achieved morphologic complete remission, and 26% had stabilization of disease during at least three courses. At 12 and 18 months after the first course of azacitidine, 33 and 10% of the patients were progression-free, respectively. Incidences of overall survival at 12 and 24 months were 54.5 and 16%, respectively. Age <75 years was associated with better overall survival. Normal leukocyte count at the first dose of azacitidine and standard doses of azacitidine were both associated with a better progression-free and overall survival. We conclude that azacitidine is feasible in patients who have failed induction chemotherapy and may be associated with prolongation of survival. A prospective trial to validate these results is warranted.

Original languageAmerican English
Pages (from-to)575-579
Number of pages5
JournalAnnals of Hematology
Volume96
Issue number4
DOIs
StatePublished - 1 Apr 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2017, Springer-Verlag Berlin Heidelberg.

Keywords

  • Acute myeloid leukemia
  • Azacitidine
  • Elderly
  • Refractory

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