The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study
Objective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of ≥60...
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Galenos Publishing House
2016-11-01
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| Series: | Turkish Journal of Hematology |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-55632 |
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| author | Anıl Tombak Mehmet Ali Uçar Aydan Akdeniz Eyüp Naci Tiftik Deniz Gören Şahin Olga Meltem Akay Murat Yıldırım Oral Nevruz Cem Kis Emel Gürkan Şerife Medeni Solmaz Mehmet Ali Özcan Rahşan Yıldırım İlhami Berber Mehmet Ali Erkurt Tülin Fıratlı Tuğlular Pınar Tarkun İrfan Yavaşoğlu Mehmet Hilmi Doğu İsmail Sarı Mustafa Merter Muhit Özcan Esra Yıldızhan Leylagül Kaynar Özgür Mehtap Ayşe Uysal Fahri Şahin Ozan Salim Mehmet Ali Sungur |
| author_facet | Anıl Tombak Mehmet Ali Uçar Aydan Akdeniz Eyüp Naci Tiftik Deniz Gören Şahin Olga Meltem Akay Murat Yıldırım Oral Nevruz Cem Kis Emel Gürkan Şerife Medeni Solmaz Mehmet Ali Özcan Rahşan Yıldırım İlhami Berber Mehmet Ali Erkurt Tülin Fıratlı Tuğlular Pınar Tarkun İrfan Yavaşoğlu Mehmet Hilmi Doğu İsmail Sarı Mustafa Merter Muhit Özcan Esra Yıldızhan Leylagül Kaynar Özgür Mehtap Ayşe Uysal Fahri Şahin Ozan Salim Mehmet Ali Sungur |
| author_sort | Anıl Tombak |
| collection | DOAJ |
| description | Objective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of ≥60 years old who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%.
Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment.nMedian overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (≥5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA. |
| first_indexed | 2024-04-10T11:04:41Z |
| format | Article |
| id | doaj.art-991999bdfbb345eea13143fc24d2544e |
| institution | Directory Open Access Journal |
| issn | 1308-5263 |
| language | English |
| last_indexed | 2024-04-10T11:04:41Z |
| publishDate | 2016-11-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Turkish Journal of Hematology |
| spelling | doaj.art-991999bdfbb345eea13143fc24d2544e2023-02-15T16:19:31ZengGalenos Publishing HouseTurkish Journal of Hematology1308-52632016-11-0133427328010.4274/tjh.2015.0203TJH-55632The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter StudyAnıl Tombak0Mehmet Ali Uçar1Aydan Akdeniz2Eyüp Naci Tiftik3Deniz Gören Şahin4Olga Meltem Akay5Murat Yıldırım6Oral Nevruz7Cem Kis8Emel Gürkan9Şerife Medeni Solmaz10Mehmet Ali Özcan11Rahşan Yıldırım12İlhami Berber13Mehmet Ali Erkurt14Tülin Fıratlı Tuğlular15Pınar Tarkun16İrfan Yavaşoğlu17Mehmet Hilmi Doğu18İsmail Sarı19Mustafa Merter20Muhit Özcan21Esra Yıldızhan22Leylagül Kaynar23Özgür Mehtap24Ayşe Uysal25Fahri Şahin26Ozan Salim27Mehmet Ali Sungur28Mersin University Faculty of Medicine, Department of Hematology, Mersin, TurkeyMersin University Faculty of Medicine, Department of Hematology, Mersin, TurkeyMersin University Faculty of Medicine, Department of Hematology, Mersin, TurkeyMersin University Faculty of Medicine, Department of Hematology, Mersin, TurkeyOsmangazi University Faculty of Medicine, Department of Hematology, Eskişehir, TurkeyOsmangazi University Faculty of Medicine, Department of Hematology, Eskişehir, TurkeyGülhane Training and Research Hospital, Clinic of Hematology, Ankara, TurkeyGülhane Training and Research Hospital, Clinic of Hematology, Ankara, TurkeyÇukurova University Faculty of Medicine, Department of Hematology, Adana, TurkeyÇukurova University Faculty of Medicine, Department of Hematology, Adana, TurkeyDokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, TurkeyDokuz Eylül University Faculty of Medicine, Department of Hematology, İzmir, TurkeyAtatürk University Faculty of Medicine, Department of Hematology, Erzurum, Turkeyİnönü University Faculty of Medicine, Department of Hematology, Malatya, Turkeyİnönü University Faculty of Medicine, Department of Hematology, Malatya, TurkeyMarmara University Faculty of Medicine, Department of Hematology, İstanbul, TurkeyKocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, TurkeyAdnan Menderes University Faculty of Medicine, Department of Hematology, Aydın, TurkeyPamukkale University Faculty of Medicine, Department of Hematology, Denizli, TurkeyPamukkale University Faculty of Medicine, Department of Hematology, Denizli, TurkeyAnkara University Faculty of Medicine, Department of Hematology, Ankara, TurkeyAnkara University Faculty of Medicine, Department of Hematology, Ankara, TurkeyErciyes University Faculty of Medicine, Department of Hematology, Kayseri, TurkeyErciyes University Faculty of Medicine, Department of Hematology, Kayseri, TurkeyKocaeli University Faculty of Medicine, Department of Hematology, Kocaeli, TurkeyEge University Faculty of Medicine, Department of Hematology, İzmir, TurkeyEge University Faculty of Medicine, Department of Hematology, İzmir, TurkeyAkdeniz University Faculty of Medicine, Department of Hematology, Antalya, TurkeyDüzce University Faculty of Medicine, Department of Biostatistics, Düzce, TurkeyObjective: In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts. Materials and Methods: In this retrospective multicenter study, 130 patients of ≥60 years old who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included. Results: The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment.nMedian overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (≥5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact. Conclusion: We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-55632azacitidineacute myeloid leukemiaelderlybone marrow blastsprognostic factorsoverall survival |
| spellingShingle | Anıl Tombak Mehmet Ali Uçar Aydan Akdeniz Eyüp Naci Tiftik Deniz Gören Şahin Olga Meltem Akay Murat Yıldırım Oral Nevruz Cem Kis Emel Gürkan Şerife Medeni Solmaz Mehmet Ali Özcan Rahşan Yıldırım İlhami Berber Mehmet Ali Erkurt Tülin Fıratlı Tuğlular Pınar Tarkun İrfan Yavaşoğlu Mehmet Hilmi Doğu İsmail Sarı Mustafa Merter Muhit Özcan Esra Yıldızhan Leylagül Kaynar Özgür Mehtap Ayşe Uysal Fahri Şahin Ozan Salim Mehmet Ali Sungur The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study Turkish Journal of Hematology azacitidine acute myeloid leukemia elderly bone marrow blasts prognostic factors overall survival |
| title | The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study |
| title_full | The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study |
| title_fullStr | The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study |
| title_full_unstemmed | The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study |
| title_short | The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study |
| title_sort | role of azacitidine in the treatment of elderly patients with acute myeloid leukemia results of a retrospective multicenter study |
| topic | azacitidine acute myeloid leukemia elderly bone marrow blasts prognostic factors overall survival |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&un=TJH-55632 |
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