Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia

Alfonso Quintás-Cardama, Farhad Ravandi, Theresa Liu-Dumlao, Mark Brandt, Stefan Faderl, Sherry Pierce, Gautam Borthakur, Guillermo Garcia-Manero, Jorge Cortes, Hagop Kantarjian

Research output: Contribution to journalArticle

Abstract

We reviewed the outcome of 671 patients 65 years of age or older with newly diagnosed acute myeloid leukemia (AML) treated at our institution between 2000 and 2010 with intensive chemotherapy (n = 557) or azacitidine- or decitabine-based therapy (n = 114). Both groups were balanced according to cytogenetics and performance status. The complete response rates with chemotherapy and epigenetic therapy were 42% and 28%, respectively (P = .001), and the 8-week mortality 18% and 11%, respectively (P = .075). Two-year relapse-free survival rates (28% vs 39%, P = .843) and median survival (6.7 vs 6.5 months, P = .413) were similar in the 2 groups. Multivariate analysis identified older age, adverse cytogenetics, poor performance status, elevated creatinine, peripheral blood and BM blasts, and hemoglobin, but not type of AML therapy, as independent prognostic factors for survival. No outcome differences were observed according to cytogenetics, FLT3 mutational status, age, or performance status by therapy type. Decitabine was associated with improved median overall survival compared with azacitidine (5.5 vs 8.8 months, respectively, P = .03). Survival after failure of intensive chemotherapy, azacitidine, or decitabine was more favorable in patients who had previously received decitabine (1.1 vs 0.9 vs 3.1 months, respectively, P = .109). The results of the present study show that epigenetic therapy is associated with similar survival rates as intensive chemotherapy in older patients with newly diagnosed AML. The studies reviewed are registered at www.clinicaltrials.gov as 2009-0172 (NCT00926731) and 2009-0217 (NCT00952588).

Original languageEnglish (US)
Pages (from-to)4840-4845
Number of pages6
JournalBlood
Volume120
Issue number24
DOIs
StatePublished - Dec 6 2012
Externally publishedYes

Fingerprint

decitabine
Chemotherapy
Azacitidine
Acute Myeloid Leukemia
Epigenomics
Drug Therapy
Survival
Cytogenetics
Survival Rate
Therapeutics
Creatinine
Hemoglobins
Blood
Multivariate Analysis
Recurrence
Mortality

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Quintás-Cardama, A., Ravandi, F., Liu-Dumlao, T., Brandt, M., Faderl, S., Pierce, S., ... Kantarjian, H. (2012). Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia. Blood, 120(24), 4840-4845. https://doi.org/10.1182/blood-2012-06-436055

Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia. / Quintás-Cardama, Alfonso; Ravandi, Farhad; Liu-Dumlao, Theresa; Brandt, Mark; Faderl, Stefan; Pierce, Sherry; Borthakur, Gautam; Garcia-Manero, Guillermo; Cortes, Jorge; Kantarjian, Hagop.

In: Blood, Vol. 120, No. 24, 06.12.2012, p. 4840-4845.

Research output: Contribution to journalArticle

Quintás-Cardama, A, Ravandi, F, Liu-Dumlao, T, Brandt, M, Faderl, S, Pierce, S, Borthakur, G, Garcia-Manero, G, Cortes, J & Kantarjian, H 2012, 'Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia', Blood, vol. 120, no. 24, pp. 4840-4845. https://doi.org/10.1182/blood-2012-06-436055
Quintás-Cardama, Alfonso ; Ravandi, Farhad ; Liu-Dumlao, Theresa ; Brandt, Mark ; Faderl, Stefan ; Pierce, Sherry ; Borthakur, Gautam ; Garcia-Manero, Guillermo ; Cortes, Jorge ; Kantarjian, Hagop. / Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia. In: Blood. 2012 ; Vol. 120, No. 24. pp. 4840-4845.
@article{c19fd4d4eb654cdb85e777eaaa028001,
title = "Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia",
abstract = "We reviewed the outcome of 671 patients 65 years of age or older with newly diagnosed acute myeloid leukemia (AML) treated at our institution between 2000 and 2010 with intensive chemotherapy (n = 557) or azacitidine- or decitabine-based therapy (n = 114). Both groups were balanced according to cytogenetics and performance status. The complete response rates with chemotherapy and epigenetic therapy were 42{\%} and 28{\%}, respectively (P = .001), and the 8-week mortality 18{\%} and 11{\%}, respectively (P = .075). Two-year relapse-free survival rates (28{\%} vs 39{\%}, P = .843) and median survival (6.7 vs 6.5 months, P = .413) were similar in the 2 groups. Multivariate analysis identified older age, adverse cytogenetics, poor performance status, elevated creatinine, peripheral blood and BM blasts, and hemoglobin, but not type of AML therapy, as independent prognostic factors for survival. No outcome differences were observed according to cytogenetics, FLT3 mutational status, age, or performance status by therapy type. Decitabine was associated with improved median overall survival compared with azacitidine (5.5 vs 8.8 months, respectively, P = .03). Survival after failure of intensive chemotherapy, azacitidine, or decitabine was more favorable in patients who had previously received decitabine (1.1 vs 0.9 vs 3.1 months, respectively, P = .109). The results of the present study show that epigenetic therapy is associated with similar survival rates as intensive chemotherapy in older patients with newly diagnosed AML. The studies reviewed are registered at www.clinicaltrials.gov as 2009-0172 (NCT00926731) and 2009-0217 (NCT00952588).",
author = "Alfonso Quint{\'a}s-Cardama and Farhad Ravandi and Theresa Liu-Dumlao and Mark Brandt and Stefan Faderl and Sherry Pierce and Gautam Borthakur and Guillermo Garcia-Manero and Jorge Cortes and Hagop Kantarjian",
year = "2012",
month = "12",
day = "6",
doi = "10.1182/blood-2012-06-436055",
language = "English (US)",
volume = "120",
pages = "4840--4845",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "24",

}

TY - JOUR

T1 - Epigenetic therapy is associated with similar survival compared with intensive chemotherapy in older patients with newly diagnosed acute myeloid leukemia

AU - Quintás-Cardama, Alfonso

AU - Ravandi, Farhad

AU - Liu-Dumlao, Theresa

AU - Brandt, Mark

AU - Faderl, Stefan

AU - Pierce, Sherry

AU - Borthakur, Gautam

AU - Garcia-Manero, Guillermo

AU - Cortes, Jorge

AU - Kantarjian, Hagop

PY - 2012/12/6

Y1 - 2012/12/6

N2 - We reviewed the outcome of 671 patients 65 years of age or older with newly diagnosed acute myeloid leukemia (AML) treated at our institution between 2000 and 2010 with intensive chemotherapy (n = 557) or azacitidine- or decitabine-based therapy (n = 114). Both groups were balanced according to cytogenetics and performance status. The complete response rates with chemotherapy and epigenetic therapy were 42% and 28%, respectively (P = .001), and the 8-week mortality 18% and 11%, respectively (P = .075). Two-year relapse-free survival rates (28% vs 39%, P = .843) and median survival (6.7 vs 6.5 months, P = .413) were similar in the 2 groups. Multivariate analysis identified older age, adverse cytogenetics, poor performance status, elevated creatinine, peripheral blood and BM blasts, and hemoglobin, but not type of AML therapy, as independent prognostic factors for survival. No outcome differences were observed according to cytogenetics, FLT3 mutational status, age, or performance status by therapy type. Decitabine was associated with improved median overall survival compared with azacitidine (5.5 vs 8.8 months, respectively, P = .03). Survival after failure of intensive chemotherapy, azacitidine, or decitabine was more favorable in patients who had previously received decitabine (1.1 vs 0.9 vs 3.1 months, respectively, P = .109). The results of the present study show that epigenetic therapy is associated with similar survival rates as intensive chemotherapy in older patients with newly diagnosed AML. The studies reviewed are registered at www.clinicaltrials.gov as 2009-0172 (NCT00926731) and 2009-0217 (NCT00952588).

AB - We reviewed the outcome of 671 patients 65 years of age or older with newly diagnosed acute myeloid leukemia (AML) treated at our institution between 2000 and 2010 with intensive chemotherapy (n = 557) or azacitidine- or decitabine-based therapy (n = 114). Both groups were balanced according to cytogenetics and performance status. The complete response rates with chemotherapy and epigenetic therapy were 42% and 28%, respectively (P = .001), and the 8-week mortality 18% and 11%, respectively (P = .075). Two-year relapse-free survival rates (28% vs 39%, P = .843) and median survival (6.7 vs 6.5 months, P = .413) were similar in the 2 groups. Multivariate analysis identified older age, adverse cytogenetics, poor performance status, elevated creatinine, peripheral blood and BM blasts, and hemoglobin, but not type of AML therapy, as independent prognostic factors for survival. No outcome differences were observed according to cytogenetics, FLT3 mutational status, age, or performance status by therapy type. Decitabine was associated with improved median overall survival compared with azacitidine (5.5 vs 8.8 months, respectively, P = .03). Survival after failure of intensive chemotherapy, azacitidine, or decitabine was more favorable in patients who had previously received decitabine (1.1 vs 0.9 vs 3.1 months, respectively, P = .109). The results of the present study show that epigenetic therapy is associated with similar survival rates as intensive chemotherapy in older patients with newly diagnosed AML. The studies reviewed are registered at www.clinicaltrials.gov as 2009-0172 (NCT00926731) and 2009-0217 (NCT00952588).

UR - http://www.scopus.com/inward/record.url?scp=84870741431&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84870741431&partnerID=8YFLogxK

U2 - 10.1182/blood-2012-06-436055

DO - 10.1182/blood-2012-06-436055

M3 - Article

C2 - 23071272

AN - SCOPUS:84870741431

VL - 120

SP - 4840

EP - 4845

JO - Blood

JF - Blood

SN - 0006-4971

IS - 24

ER -