Long-term survival after intensive chemotherapy or hypomethylating agents in AML patients aged 70 years and older: a large patient data set study from European registries

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作者
Christian Récher
Christoph Röllig
Emilie Bérard
Sarah Bertoli
Pierre-Yves Dumas
Suzanne Tavitian
Michael Kramer
Hubert Serve
Martin Bornhäuser
Uwe Platzbecker
Carsten Müller-Tidow
Claudia D. Baldus
David Martínez-Cuadrón
Josefina Serrano
Pilar Martínez-Sánchez
Eduardo Rodríguez Arbolí
Cristina Gil
Juan Bergua
Teresa Bernal
Adolfo de la Fuente Burguera
Eric Delabesse
Audrey Bidet
Arnaud Pigneux
Pau Montesinos
机构
[1] Centre Hospitalier Universitaire de Toulouse,Instituto de Investigación Sanitaria La Fe (IISLAFE)
[2] Institut Universitaire du Cancer de Toulouse Oncopole,undefined
[3] Université Toulouse III Paul Sabatier,undefined
[4] Medizinische Klinik und Poliklinik I,undefined
[5] Universitätsklinikum TU Dresden,undefined
[6] Centre Hospitalier Universitaire de Toulouse,undefined
[7] Service d’Epidémiologie,undefined
[8] CERPOP,undefined
[9] Inserm,undefined
[10] Université Toulouse III Paul Sabatier,undefined
[11] CHU Bordeaux,undefined
[12] Service d’Hématologie Clinique et de Thérapie Cellulaire,undefined
[13] Université de Bordeaux,undefined
[14] Institut National de la Santé et de la Recherche Médicale,undefined
[15] U1035,undefined
[16] Medizinische Klinik 2,undefined
[17] Universitätsklinikum Frankfurt,undefined
[18] Klinik und Poliklinik für Hämatologie,undefined
[19] Zelltherapie und Hämostaseologie,undefined
[20] Universitätsklinikum Leipzig,undefined
[21] Klinik für Hämatologie,undefined
[22] Onkologie und Rheumatologie,undefined
[23] Universitätsklinikum Heidelberg,undefined
[24] Klinik für Innere Medizin II,undefined
[25] Universitätsklinikum Schleswig-Holstein,undefined
[26] Hospital Universitari i Politècnic La Fe,undefined
[27] Hospital Universitario Reina Sofía-IMIBIC,undefined
[28] Hospital Universitario 12 de Octubre,undefined
[29] Hospital Universitario Virgen del Rocío,undefined
[30] Hospital General Universitario de Alicante,undefined
[31] Hospital San Pedro Alcántara,undefined
[32] Hospital Universitario Central de Asturias,undefined
[33] MD Anderson Cancer Center Madrid,undefined
[34] Centre Hospitalier Universitaire de Toulouse,undefined
[35] Institut Universitaire du Cancer de Toulouse Oncopole,undefined
[36] Laboratoire d’Hématologie Biologique,undefined
[37] CHU Bordeaux,undefined
[38] Laboratoire d’Hématologie Biologique,undefined
来源
Leukemia | 2022年 / 36卷
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摘要
The outcome of acute myeloid leukemia patients aged 70 years or older is poor. Defining the best treatment option remains controversial especially when choosing between intensive chemotherapy and hypomethylating agents. We set up a multicentric European database collecting data of 3 700 newly diagnosed acute myeloid leukemia patients ≥70 years. The primary objective was to compare overall survival in patients selected for intensive chemotherapy (n = 1199) or hypomethylating agents (n = 1073). With a median follow-up of 49.5 months, the median overall survival was 10.9 (95% CI: 9.7–11.6) and 9.2 months (95% CI: 8.3–10.2) with chemotherapy and hypomethylating agents, respectively. Complete remission or complete remission with incomplete hematologic recovery was 56.1% and 19.7% with chemotherapy and hypomethylating agents, respectively (P < 0.0001). Treatment effect on overall survival was time-dependent. The Royston and Parmar model showed that patients treated with hypomethylating agents had a significantly lower risk of death before 1.5 months of follow-up; no significant difference between 1.5 and 4.0 months, whereas patients treated with intensive chemotherapy had a significantly better overall survival from four months after start of therapy. This study shows that intensive chemotherapy remains a valuable option associated with a better long-term survival in older AML patients.
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页码:913 / 922
页数:9
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