High-dose homoharringtonine versus standard-dose daunorubicin is effective and safe as induction and post-induction chemotherapy for elderly patients with acute myeloid leukemia: a multicenter experience from China.
The purpose of the study was to compare the antitumor efficacy and safety profile of high-dose homoharringtonine as induction and post-induction therapy compared to either standard-dose homoharringtonine or daunorubicin in elderly patients with newly diagnosed acute myeloid leukemia. A total of 254 patients, age range 60-77 years received induction and post-induction therapy containing daunorubicin, standard-dose homoharringtonine, or high-dose homoharringtonine. After one course of induction therapy, the overall complete remission rate was similar between treatment arms (58.7%, P = .92). Among 161 patients with acute myeloid leukemia (non-M5 subtype), estimated median overall survival was 39, 29, and 37 months, respectively, in the daunorubicin, standard-dose homoharringtonine, and high-dose homoharringtonine treatment groups (P = .53). In the 93 patients with acute myeloid leukemia-M5 subtype, there was a significant difference in estimated median overall survival: 24, 24, and 52 months, respectively, in the daunorubicin, standard-dose homoharringtonine, and high-dose homoharringtonine treatment groups (P = .003). There was no significant difference in drug-related adverse events between treatment arms. High-dose homoharringtonine does not clearly increase the complete remission rate of elderly patients with acute myeloid leukemia. However, in the subset of elderly patients with acute monocytic leukemia, high-dose homoharringtonine as a first-line regimen prolonged overall survival with minimal toxicity.
Department of Hematology Medicine, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, 510515 Guangzhou, People's Republic of China.
Bin-Tao
BT
Huang
Qing-Chun
QC
Zeng
Jessica
J
Yu
Xiao-Li
XL
Liu
Zhen
Z
Xiao
Hong-Qian
HQ
Zhu
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002681:China; D003630:Daunorubicin / Q000627:therapeutic use; D005260:Female; D006248:Harringtonines / Q000008:administration & dosage* / Q000009:adverse effects; D000077863:Homoharringtonine; D006801:Humans; D060828:Induction Chemotherapy / Q000379:methods*; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models
D000970:Antineoplastic Agents; D006248:Harringtonines; D000077863:Homoharringtonine; D003630:Daunorubicin
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