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Amsacrine-based induction therapy in AML patients with cardiac comorbidities: a retrospective single-center analysis.
Kuron, David; Pohlmann, Alexander; Angenendt, Linus; Kessler, Torsten; Mesters, Rolf; Berdel, Wolfgang E; Stelljes, Matthias; Lenz, Georg; Schliemann, Christoph; Mikesch, Jan-Henrik.
Afiliación
  • Kuron D; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany. David.kuron@uksh.de.
  • Pohlmann A; Current Affiliation: Department of Medicine II, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany. David.kuron@uksh.de.
  • Angenendt L; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Kessler T; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Mesters R; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Berdel WE; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Stelljes M; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Lenz G; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Schliemann C; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
  • Mikesch JH; Department of Medicine A, University Hospital Münster, 48149, Münster, Germany.
Ann Hematol ; 102(4): 755-760, 2023 Apr.
Article en En | MEDLINE | ID: mdl-36749402
Intensive chemotherapy is the backbone of induction treatment in patients with acute myeloid leukemia (AML). However, AML patients with concomitant cardiac disease may not be eligible for anthracycline-based therapies. In a small cohort of patients, we have previously shown that anthracycline-free, amsacrine-based chemotherapy TAA (thioguanine, cytarabine, amsacrine) may be as effective as cytarabine/daunorubicin for induction therapy in these patients. In this systematic retrospective single-center analysis, we documented the outcome of 31 patients with significant cardiac comorbidities including coronary heart disease or cardiomyopathy receiving TAA as induction chemotherapy. Median (range) ejection fraction (EF) was 48% (30-67%) in this cohort. Patients with EF below 30% were considered unfit for intensive induction therapy. Event-free survival (EFS), overall survival (OS), and relapse-free survival (RFS) were 1.61, 5.46, and 13.6 months respectively. Poor outcome was primarily related to a high early mortality rate within the first 30 days of therapy, mainly caused by infectious complications. TAA cannot be recommended as a substitute of standard induction for AML patients with significant concomitant cardiac disease. In the era of novel agents, alternative strategies (e.g., hypomethylating agents plus venetoclax) should be considered when anthracycline-based regimens are not suitable.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda / Cardiopatías Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Mieloide Aguda / Cardiopatías Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Ann Hematol Asunto de la revista: HEMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania