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Identification of Predictive Factors for Overall Survival and Response during Hypomethylating Treatment in Very Elderly (≥75 Years) Acute Myeloid Leukemia Patients: A Multicenter Real-Life Experience.
Molica, Matteo; Mazzone, Carla; Niscola, Pasquale; Carmosino, Ida; Di Veroli, Ambra; De Gregoris, Cinzia; Bonanni, Fabrizio; Perrone, Salvatore; Cenfra, Natalia; Fianchi, Luana; Piccioni, Anna Lina; Spadea, Antonio; Luzi, Giovanni; Mengarelli, Andrea; Cudillo, Laura; Maurillo, Luca; Pagano, Livio; Breccia, Massimo; Rigacci, Luigi; De Fabritiis, Paolo.
Afiliación
  • Molica M; Hematology and Stem Cell Transplant Unit, St. Eugenio Hospital, 00144 Rome, Italy.
  • Mazzone C; Hematology and Stem Cell Transplant Unit, St. Eugenio Hospital, 00144 Rome, Italy.
  • Niscola P; Hematology and Stem Cell Transplant Unit, St. Eugenio Hospital, 00144 Rome, Italy.
  • Carmosino I; Hematology, Department of Translational and Precision Medicine, Policlinico Umberto I, Sapienza University, 00185 Rome, Italy.
  • Di Veroli A; Hematology Division, Ospedale Belcolle, 01100 Viterbo, Italy.
  • De Gregoris C; Hematology Division, Ospedale Belcolle, 01100 Viterbo, Italy.
  • Bonanni F; Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy.
  • Perrone S; Hematology, Polo Universitario Pontino, S.M. Goretti Hospital, 04100 Latina, Italy.
  • Cenfra N; Hematology, Polo Universitario Pontino, S.M. Goretti Hospital, 04100 Latina, Italy.
  • Fianchi L; Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Piccioni AL; Hematology and Stem Cell Transplant, San Giovanni Addolorata, 00184 Rome, Italy.
  • Spadea A; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy.
  • Luzi G; Hematology and Stem Cell Transplant, San Camillo Forlanini Hospital, 00152 Rome, Italy.
  • Mengarelli A; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy.
  • Cudillo L; Hematology and Stem Cell Transplant, San Giovanni Addolorata, 00184 Rome, Italy.
  • Maurillo L; Hematology, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy.
  • Pagano L; Institute of Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.
  • Breccia M; Hematology, Department of Translational and Precision Medicine, Policlinico Umberto I, Sapienza University, 00185 Rome, Italy.
  • Rigacci L; Hematology and Stem Cell Transplant, San Camillo Forlanini Hospital, 00152 Rome, Italy.
  • De Fabritiis P; Hematology and Stem Cell Transplant Unit, St. Eugenio Hospital, 00144 Rome, Italy.
Cancers (Basel) ; 14(19)2022 Oct 06.
Article en En | MEDLINE | ID: mdl-36230820
Elderly patients represent the most challenging and hard-to-treat patient population due to dismal characteristics of the disease, such as secondary-acute myeloid leukemia (AML), enrichment of unfavorable molecular genes (TP53) and comorbidities. We conducted a multicentric retrospective study to evaluate activity and safety in a real-life setting of hypomethylating drugs (HMAs) in patients older than 75 years with AML. Between September 2010 and December 2021, 220 patients were treated, 164 (74.5%) received AZAcitidine and 56 DECitabine; most patients (57.8%), received more than four cycles of HMAs. The best response obtained was CR in 51 patients (23.2%), PR in 23 (10.5%) and SD in 45 (20.5%); overall transfusion independence was obtained in 47 patients (34%), after a median of 3.5 months. The median OS (mOs) was 8 months (95% CI 5.9-10.2), with 1- and 2-years OS of 39.4% (95% CI 32.7-46) and 17.4% (95% CI 11.7-23.1), respectively; similar mOS was observed according to HMA treatment (AZA 8.3 vs. DEC 7.8 months, p = 0.810). A subset of 57 long survivors (44 in AZA group and 13 in DEC group) received at least 12 cycles of HMAs, their mOS was 24.3 months. In multivariate analysis, age (≥80), Charlson comorbidity index (≥3), creatinine clearance and the type of best response (≥PR) during treatment maintained independent significance in predicting survival. Infectious complications, most frequently pneumonia (35) and septic shock (12), were lethal in 49 patients (22.2%). Our data show that HMAs have similar efficacy compared to pivotal trials and are well tolerated in a setting of very elderly patients with several co-comorbidities.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Cancers (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Cancers (Basel) Año: 2022 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza