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Atalay F, Ateşoğlu EB. Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2). Indian J Hematol Blood Transfus. 2015;32(1):46-53doi: 10.1007/s12288-015-0509-2.
Atalay, F., & Ateşoğlu, E. B. (2016). Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2). Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion, 32(1), 46-53. https://doi.org/10.1007/s12288-015-0509-2
Atalay, Figen, and Ateşoğlu, Elif Birtaş. "Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2)." Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion vol. 32,1 (2016): 46-53. doi: https://doi.org/10.1007/s12288-015-0509-2
Atalay F, Ateşoğlu EB. Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2). Indian J Hematol Blood Transfus. 2016 Mar;32(1):46-53. doi: 10.1007/s12288-015-0509-2. Epub 2015 Feb 01. PMID: 26855506; PMCID: PMC4733667.
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Indian J Hematol Blood Transfus. 2016 Mar;32(1):46-53. doi: 10.1007/s12288-015-0509-2. Epub 2015 Feb 01.

Low Dose Cytosine Arabinoside and Azacitidine Combination in Elderly Patients with Acute Myeloid Leukemia and Refractory Anemia with Excess Blasts (MDS-RAEB2).

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion

Figen Atalay, Elif Birtaş Ateşoğlu

Affiliations

  1. Department of Hematology, Baskent University School of Medicine, Oymac? Sok No 7 Altunizade, Uskudar, ?stanbul, Turkey.
  2. Department of Hematology, Kocaeli University School of Medicine, Kocaeli, Turkey.

PMID: 26855506 PMCID: PMC4733667 DOI: 10.1007/s12288-015-0509-2

Abstract

Only one-third of elderly (>60 years) AML and MDS-RAEB2 patients may receive intensive chemotherapy treatment alternatives that are limited in this patient group due to the potential of severe toxicity. Previous studies have shown that azacitidine and low dose cytarabine treatments may be a beneficial treatment option for these patients. In this study, we aimed to good results with low toxicity in elderly patients. We retrospectively analyzed the AML and MDS-RAEB2 patients who received azacitidine monotherapy and azacitidine and LDL-ara-c combination therapy for a comparison of their response to therapy, survival rates, and toxicity rates and for determining the factors that could affect their overall survival. A total of 27 patients who were diagnosed with de novo AML and MDS-RAEB2 and who received at least four cycles of chemotherapy were included in the study, and the data were evaluated retrospectively. When monotherapy and combination therapy groups were compared, the pretreatment bone marrow blast count was observed to be greater in the combination therapy group. A statistically significant difference was not detected between the groups regarding the response to therapy ratios (p = 0.161) (42.9 and 57.1 %, respectively). No difference was detected between the groups regarding therapy-related toxicity. Infections were the most common complication. Progression-free survival was 30.3 % for the azacitidine monotherapy group and 66.7 % for the combination (azacitidine + LD-ara-c) group. The factors influencing the overall survival rate were determined based on the response to the first-line therapies, more than a grade 2 infection, fever, and relapse in a multi-variance analysis. The combination therapy may be a well-tolerated treatment option for the elderly, vulnerable AML patients whose blast count is high in response to therapy rates, overall survival rates, and toxicities are not different, although the pre-treatment bone marrow blast count was greater in the combination therapy groups compared with the monotherapy group.

Keywords: Acute myeloid leukemia; Azacitidine; Elderly; Low dose cytarabine

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