Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study
Data on the use of azacytidine and decitabine as salvage therapy for acute myeloid leukemia are limited. We retrospectively reviewed clinical records of 100 patients treated with hypomethylating agents (HMA) as salvage therapy in nine Italian institutions. A total of 24% of patients obtained a respo...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-08-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/9/8/972 |
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| author | Federica Lessi Marica Laurino Cristina Papayannidis Orsola Vitagliano Francesco Grimaldi Davide Lazzarotto Michele Gottardi Elena Crisà Marta Riva Gianluigi Reda Mario Ermani Gianpietro Semenzato Livio Trentin Felicetto Ferrara |
| author_facet | Federica Lessi Marica Laurino Cristina Papayannidis Orsola Vitagliano Francesco Grimaldi Davide Lazzarotto Michele Gottardi Elena Crisà Marta Riva Gianluigi Reda Mario Ermani Gianpietro Semenzato Livio Trentin Felicetto Ferrara |
| author_sort | Federica Lessi |
| collection | DOAJ |
| description | Data on the use of azacytidine and decitabine as salvage therapy for acute myeloid leukemia are limited. We retrospectively reviewed clinical records of 100 patients treated with hypomethylating agents (HMA) as salvage therapy in nine Italian institutions. A total of 24% of patients obtained a response to HMA (CR, PR, or CRi), while 26% showed a stable disease (SD); 50% of patients experienced progressive disease. Median OS was 6.5 months. OS in patients with de novo AML was 6.1 months, while OS in patients with secondary AML (sAML) was 12.3 months (<i>p</i> = 0.037). Median OS after HMA in patients with SD as best response to HMA was similar to median OS in patients with response to HMA (10.6 months vs. 13 months). On multivariate analysis, OS difference between patients who obtained a response versus patients who did not was significant (<i>p</i> = 0.0037). OS difference in sAML was significantly better than in de novo AML (<i>p</i> < 0.00001). HMA showed a remarkable efficacy in terms of response rate and OS in a subgroup of patients (sAMLs), historically characterized by a poor outcome. Therefore, 5Azacitidine and decitabine may represent a good clinical option in a selected patient population with relapsed or refractory AML, unsuitable for allo-HSCT. |
| first_indexed | 2024-03-10T08:59:58Z |
| format | Article |
| id | doaj.art-fd58561aa7fe4946ae608bffa68a5279 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T08:59:58Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-fd58561aa7fe4946ae608bffa68a52792023-11-22T06:52:46ZengMDPI AGBiomedicines2227-90592021-08-019897210.3390/biomedicines9080972Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective StudyFederica Lessi0Marica Laurino1Cristina Papayannidis2Orsola Vitagliano3Francesco Grimaldi4Davide Lazzarotto5Michele Gottardi6Elena Crisà7Marta Riva8Gianluigi Reda9Mario Ermani10Gianpietro Semenzato11Livio Trentin12Felicetto Ferrara13Hematology Unit, Department of Medicine (DIMED), Azienda Ospedale Università Padova, 35100 Padova, ItalyHematology Unit, Department of Medicine (DIMED), Azienda Ospedale Università Padova, 35100 Padova, ItalyDepartment of Hematology and Oncology “L. and A. Seràgnoli” S.Orsola Malpighi University Hospital, 40100 Bologna, ItalyDivision of Hematology, Cardarelli Hospital, 80100 Naples, ItalyDepartment of Medicina Clinica e Chirurgia, AOU Federico II di Napoli, 80100 Naples, ItalyHematology and SCT Unit, University of Udine, Azienda Sanitaria Universitaria Integrata di Udine, 33100 Udine, ItalyHematology, Treviso Hospital, 31100 Treviso, ItalyDivision of Hematology, Department of Translational Medicine, Università del Piemonte Orientale and Ospedale Maggiore della Carità, 28100 Novara, ItalyHematology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, ItalyHematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, 20162 Milano, ItalyStatistic and Informatics Unit, Department of Neurosciences, School of Medicine, University of Padua, 35100 Padua, ItalyHematology Unit, Department of Medicine (DIMED), Azienda Ospedale Università Padova, 35100 Padova, ItalyHematology Unit, Department of Medicine (DIMED), Azienda Ospedale Università Padova, 35100 Padova, ItalyDivision of Hematology, Cardarelli Hospital, 80100 Naples, ItalyData on the use of azacytidine and decitabine as salvage therapy for acute myeloid leukemia are limited. We retrospectively reviewed clinical records of 100 patients treated with hypomethylating agents (HMA) as salvage therapy in nine Italian institutions. A total of 24% of patients obtained a response to HMA (CR, PR, or CRi), while 26% showed a stable disease (SD); 50% of patients experienced progressive disease. Median OS was 6.5 months. OS in patients with de novo AML was 6.1 months, while OS in patients with secondary AML (sAML) was 12.3 months (<i>p</i> = 0.037). Median OS after HMA in patients with SD as best response to HMA was similar to median OS in patients with response to HMA (10.6 months vs. 13 months). On multivariate analysis, OS difference between patients who obtained a response versus patients who did not was significant (<i>p</i> = 0.0037). OS difference in sAML was significantly better than in de novo AML (<i>p</i> < 0.00001). HMA showed a remarkable efficacy in terms of response rate and OS in a subgroup of patients (sAMLs), historically characterized by a poor outcome. Therefore, 5Azacitidine and decitabine may represent a good clinical option in a selected patient population with relapsed or refractory AML, unsuitable for allo-HSCT.https://www.mdpi.com/2227-9059/9/8/972azacytidinedecitabineHMArelapsedrefractoryacute myeloid leukemia |
| spellingShingle | Federica Lessi Marica Laurino Cristina Papayannidis Orsola Vitagliano Francesco Grimaldi Davide Lazzarotto Michele Gottardi Elena Crisà Marta Riva Gianluigi Reda Mario Ermani Gianpietro Semenzato Livio Trentin Felicetto Ferrara Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study Biomedicines azacytidine decitabine HMA relapsed refractory acute myeloid leukemia |
| title | Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study |
| title_full | Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study |
| title_fullStr | Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study |
| title_full_unstemmed | Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study |
| title_short | Hypomethylating Agents (HMAs) as Salvage Therapy in Relapsed or Refractory AML: An Italian Multicentric Retrospective Study |
| title_sort | hypomethylating agents hmas as salvage therapy in relapsed or refractory aml an italian multicentric retrospective study |
| topic | azacytidine decitabine HMA relapsed refractory acute myeloid leukemia |
| url | https://www.mdpi.com/2227-9059/9/8/972 |
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