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Leukemia & Lymphoma Volume 61, 2020 - Issue 4
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Original Articles

Prolonged administration of low-dose cytarabine and thioguanine in elderly patients with acute myeloid leukaemia (AML) achieves high complete remission rates and prolonged survival

Christopher ArthurDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Anthony JeffreyDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Eva YipDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Vicki KatsioulasDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Anastasios NalpantidisDepartment of Clinical Haematology, Monash Health, Clayton, Australia;
,
Ian KerridgeDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia; ;Department of Medicine, University of Sydney, Sydney, Australia;
,
Matthew GreenwoodDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia; ;Department of Medicine, University of Sydney, Sydney, Australia;
,
Luke CoyleDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Naomi MackinlayDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Keith FayDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia;
,
Anoop EnjetiDepartment of Haematology, Pathology North, John Hunter Hospital, Newcastle, Australia;
,
Jake ShorttDepartment of Clinical Haematology, Monash Health, Clayton, Australia; ;School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
&
William StevensonDepartment of Haematology and Transfusion Medicine, Royal North Shore Hospital, St Leonards, Sydney, Australia; ;Department of Medicine, University of Sydney, Sydney, Australia; Correspondence[email protected]
 show all
Pages 831-839 | Received 13 May 2019, Accepted 22 Nov 2019, Published online: 06 Dec 2019
 
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Abstract

The prognosis of AML in elderly patients is poor and research into novel therapeutic approaches is urgently needed. This study examined the use of low-dose chemotherapy with cytarabine and thioguanine administered in repetitive cycles in 62 elderly patients with newly diagnosed or relapsed/refractory AML. The overall response rate was 58% in the total cohort. Response rates (CR/CRi) were significantly higher in patients with newly diagnosed AML (74%) compared to patients with relapsed/refractory disease (25%, p = .0004). Kaplan–Meier estimate of overall survival was 289 days (95% CI; 183–395 days) with a relapse rate of 65.7%. The induction mortality rate was 16.1% with treatment successfully undertaken in the outpatient setting. Similar clinical outcomes were observed in a retrospective analysis of a second cohort of 25 AML patients treated at a different site. These results support the use of a sustained low intensity chemotherapy approach as a therapeutic option for elderly patients with AML.

Disclosure statement

The authors report no conflict of interest.

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