title: Deferasirox and vitamin D improves overall survival in elderly patients with acute myeloid leukemia after demethylating agents failure.
abstract: The prognosis of acute myeloid leukemia (AML) in elderly (≥65 years) patients is poor and treatment remains non-consensual especially for those who are not eligible for intensive therapies. Our group has shown that in vitro the iron chelator deferasirox (DFX) synergizes with vitamin D (VD) to promote monocyte differentiation in primary AML cells. Herein, we present results from a retrospective case-control study in which the association of DFX (1-2 g/d) and 25-hydroxycholecalciferol (100,000 IU/week) (DFX/VD) was proposed to patients following demethylating agents failure. Median survival of patients treated with DFX/VD combination (n = 17) was significantly increased in comparison with matched patients receiving best supportive care (BSC) alone (n = 13) (10.4 versus 4 months respectively). In addition, the only factor associated to an increased overall survival in DFX/VD-treated patients was serum VD levels. We conclude that DFX/VD treatment correlated with increased overall survival of AML patients in this retrospective cohort of elderly patients.
authors.affiliation: CNRS UMR 8147, Université Paris Descartes, Faculté de Médecine, Hôpital Necker, Paris, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Paubelle
authors.forename: Florence
authors.initials: F
authors.lastname: Zylbersztejn
authors.forename: Sawsaneh
authors.initials: S
authors.lastname: Alkhaeir
authors.forename: Felipe
authors.initials: F
authors.lastname: Suarez
authors.forename: Céline
authors.initials: C
authors.lastname: Callens
authors.forename: Michaël
authors.initials: M
authors.lastname: Dussiot
authors.forename: Françoise
authors.initials: F
authors.lastname: Isnard
authors.forename: Marie-Thérèse
authors.initials: MT
authors.lastname: Rubio
authors.forename: Gandhi
authors.initials: G
authors.lastname: Damaj
authors.forename: Norbert-Claude
authors.initials: NC
authors.lastname: Gorin
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marolleau
authors.forename: Renato C
authors.initials: RC
authors.lastname: Monteiro
authors.forename: Ivan C
authors.initials: IC
authors.lastname: Moura
authors.forename: Olivier
authors.initials: O
authors.lastname: Hermine
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology / Q000627:therapeutic use*; D001374:Azacitidine / Q000494:pharmacology* / Q000627:therapeutic use; D001565:Benzoates / Q000008:administration & dosage; D016022:Case-Control Studies; D002454:Cell Differentiation / Q000187:drug effects; D004248:DNA (Cytosine-5-)-Methyltransferases / Q000037:antagonists & inhibitors; D000077588:Deferasirox; D019008:Drug Resistance, Neoplasm; D004357:Drug Synergism; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D022423:Myeloid Cells / Q000187:drug effects / Q000502:physiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D014230:Triazoles / Q000008:administration & dosage; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D001565:Benzoates; D014230:Triazoles; D014807:Vitamin D; D004248:DNA (Cytosine-5-)-Methyltransferases; D001374:Azacitidine; D000077588:Deferasirox