Fludarabine, cytarabine, and attenuated-dose idarubicin (m-FLAI) combination therapy for elderly acute myeloid leukemia patients

Title
Fludarabine, cytarabine, and attenuated-dose idarubicin (m-FLAI) combination therapy for elderly acute myeloid leukemia patients
Author(s)
김민경김인호[김인호]고영길[고영길]윤성수[윤성수]김병국[김병국]김대영[김대영]이정희[이정희]이제환[이제환]정준원[정준원]민유홍[민유홍]김성현[김성현]김혁[김혁]이규형[이규형]이홍기[이홍기]주영돈[주영돈]이상민[이상민]원종호[원종호]박성규[박성규]홍대식[홍대식]김세형[김세형]손상균[손상균]박은경[박은경]김철수[김철수]박무림[박무림]
Keywords
COUNCIL AML11 TRIAL; OLDER PATIENTS; PHASE-II; ARA-C; MYELODYSPLASTIC SYNDROMES; INDUCTION CHEMOTHERAPY; GEMTUZUMAB OZOGAMICIN; CYTOSINE-ARABINOSIDE; PROGNOSTIC-FACTORS; P-GLYCOPROTEIN
Issue Date
201301
Publisher
WILEY-BLACKWELL
Citation
AMERICAN JOURNAL OF HEMATOLOGY, v.88, no.1, pp.10 - 15
Abstract
We performed a phase II trial to evaluate the efficacy and safety of the modified fludarabine, cytarabine, and attenuated-dose idarubicin (m-FLAI) regimen in elderly acute myeloid leukemia (AML) patients. Elderly (=60 years) AML patients who had not previously received chemotherapy were enrolled in the study. Patients received two consecutive cycles of m-FLAI chemotherapy as an induction. The m-FLAI regimen comprised fludarabine (25 mg/m2, days 14), cytarabine (1,000 mg/m2, days 14), and attenuated-dose idarubicin (5 mg/m2, days 13). The primary end point was complete remission (CR) rate. Secondary end points were overall survival (OS), event-free survival (EFS), and treatment-related mortality (TRM). There were 108 patients (median age 68.4 years, M:F = 64:44) enrolled in the study. CR was achieved in 56.5% of patients, and the TRM rate was 21.3%. Median OS and median EFS were 10.2 and 6.6 months, respectively. The mortality at 30 and 60 days was 15 and 21%, respectively. Performance status and comorbidity did not have prognostic value in this patient cohort. Bone marrow expression of CD117 was associated with increased EFS and OS. m-FLAI is an effective induction regimen for previously untreated AML in elderly patients. In addition, bone-marrow CD117 expression is an independent favorable prognostic factor in elderly AML patients. (ClinicalTrials.gov number, NCT01247493). Am. J. Hematol. 2013. (c) 2012 Wiley Periodicals, Inc.
URI
http://hdl.handle.net/YU.REPOSITORY/26773http://dx.doi.org/10.1002/ajh.23337
ISSN
0361-8609
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의과대학 > 내과학교실 > Articles
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