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Budziszewska, Bożena Katarzyna; Salomon-Perzyński, Aleksander; Pruszczyk, Katarzyna; Barankiewicz, Joanna; Pluta, Agnieszka; Helbig, Grzegorz; Janowska, Anna; Kuydowicz, Marta; Bołkun, Łukasz; Piszcz, Jarosław; Patkowska, Elżbieta; Wątek, Marzena; Małecki, Piotr; Kościołek-Zgódka, Sylwia; Cichocka, Edyta; Charliński, Grzegorz; Irga-Staniukiewicz, Anna; Zaucha, Jan Maciej; Piekarska, Agnieszka; Gromek, Tomasz; Hus, Marek; Wójcik, Karol; Raźny, Małgorzata; Sędzimirska, Mariola; Puła, Bartosz; Giebel, Sebastian; Grosicki, Sebastian; Wierzbowska, Agnieszka; Lech-Marańda, Ewa
Cancers, 08/2021, Letnik: 13, Številka: 16Journal Article
Acute myeloid leukemia (AML) in older unfit patients is a therapeutic challenge for clinical hematologists. We evaluated the efficacy and safety of a novel low-intensity regimen consisting of low-dose cytarabine and cladribine (LD-AC+cladribine) in first-line treatment of elderly (≥60 years) AML patients not eligible for intensive chemotherapy (IC) who had either the Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 or the hematopoietic cell transplantation comorbidity index (HCT-CI) score ≥3. The induction phase included two cycles of LD-AC+cladribine. Patients who achieved at least partial remission (PR) received maintenance treatment with LD-AC alone. Overall, 117 patients with a median age of 70 years were enrolled. Adverse cytogenetics, ECOG PS ≥2 and HCT-CI score ≥3 was observed in 43.5%, 60%, and 58% of patients, respectively. The response rate (≥PR) was 54% (complete remission CR, 32%; CR with incomplete hematologic recovery CRi, 5%). A median overall survival (OS) was 21 and 8.8 months in CR/CRi and PR group, respectively. Advanced age (≥75 years) and adverse cytogenetics had a negative impact on OS. The 56-day mortality rate was 20.5%. In conclusion, LD-AC+cladribine is a beneficial therapeutic option with a predictable safety profile in elderly AML patients not eligible for IC.
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Leto | Faktor vpliva | Izdaja | Kategorija | Razvrstitev | ||||
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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