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Decitabine as a First-Line Treatment for Older Adults Newly Diagnosed with Acute Myeloid Leukemia

Authors
 Hyunsung Park  ;  Haerim Chung  ;  Jungyeon Lee  ;  Jieun Jang  ;  Yundeok Kim  ;  Soo Jeong Kim  ;  Jin Seok Kim  ;  Yoo Hong Min  ;  June-Won Cheong 
Citation
 Yonsei Medical Journal, Vol.58(1) : 35-42, 2017 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2017
MeSH
Aged ; Antimetabolites, Antineoplastic/administration & dosage ; Antimetabolites, Antineoplastic/therapeutic use* ; Azacitidine/analogs & derivatives* ; Azacitidine/therapeutic use ; DNA Methylation ; Female ; Humans ; Leukemia, Myeloid, Acute/drug therapy* ; Leukemia, Myeloid, Acute/mortality ; Male ; Middle Aged ; Remission Induction ; Republic of Korea ; Retrospective Studies ; Treatment Outcome
Keywords
AML ; Decitabine ; elderly ; treatment
Abstract
PURPOSE: Decitabine, a DNA hypomethylating agent, was recently approved for use in Korea for older adults with acute myeloid leukemia (AML) who are not candidates for standard chemotherapy. This study aimed to evaluate the role of decitabine as a first-line treatment for older adults with AML. MATERIALS AND METHODS: Twenty-four patients with AML who received at least one course of decitabine (20 mg/m²/d intravenously for 5 days every 4 weeks) as a first-line therapy at Severance Hospital were evaluated retrospectively. RESULTS: The median age of the patients was 73.5 years. The longest follow-up duration was 502 days. A total of 113 cycles of treatment were given to 24 patients, and the median number of cycles was four (range, 1-14). Thirteen patients dropped out because of death, no or loss of response, patient refusal, or transfer to another hospital. Twenty-one (87.5%) and 12 (50%) patients completed the second and fourth cycles, respectively, and responses to treatment were evaluated in 17. A complete response (CR) or CR with incomplete blood-count recovery was achieved in six (35.3%) patients, and the estimated median overall survival was 502 days. Ten patients developed grade >2 hematologic or non-hematologic toxicities. In univariate analysis, bone marrow blasts, lactate dehydrogenase, serum ferritin level, and bone marrow iron were significantly associated with response to decitabine. CONCLUSION: Five-day decitabine treatment showed acceptable efficacy in older patients with AML who are unfit for conventional chemotherapy, with a CR rate 35.3% and about a median overall survival of 18 months.
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DOI
10.3349/ymj.2017.58.1.35
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yun Deok(김윤덕) ORCID logo https://orcid.org/0000-0002-5336-7936
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Park, Hyeun Sung(박현성)
Lee, Jung Yoen(이정연)
Jang, Ji Eun(장지은) ORCID logo https://orcid.org/0000-0001-8832-1412
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154708
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