title: Post hoc analysis of the relationship between baseline white blood cell count and survival outcome in a randomized Phase III trial of decitabine in older patients with newly diagnosed acute myeloid leukemia.
abstract: BACKGROUND
  In a Phase III trial, 485 patients (≥65 years) with newly diagnosed acute myeloid leukemia received decitabine 20 mg/m(2) intravenously for 5 days every 4 weeks or a treatment choice (supportive care or cytarabine 20 mg/m(2) subcutaneously for 10 days every 4 weeks).
  
  
  METHODS
  We summarized overall and progression-free survival by baseline white blood cell count using two analyses: <1, 1-5, >5×10(9)/L; ≤10 or >10×10(9)/L.
  
  
  RESULTS
  There were 446 deaths (treatment choice, n=227; decitabine, n=219). Median overall survival was 5.0 (treatment choice) versus 7.7 months (decitabine; nominal P=0.037). Overall survival differences between white blood cell groups were not significant; hazard ratios (HRs) favored decitabine. Significant progression-free survival differences favored decitabine for groups 1-5×10(9)/L (P=0.005, HR =0.67), greater than 5×10(9)/L (P=0.027, HR =0.71), and up to 10×10(9)/L (P=0.003, HR =0.72).
  
  
  CONCLUSIONS
  There was a trend toward improved outcome with decitabine, regardless of baseline white blood cell count.
authors: Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia.
authors: Christopher
authors: C
authors: Arthur
authors: Institute of Hematology and Blood Transfusion, Prague, Czech Republic.
authors: Jaroslav
authors: J
authors: Cermak
authors: Department of Clinical Hematology, University of Nantes, Nantes, France.
authors: Jacques
authors: J
authors: Delaunay
authors: Department of Internal Medicine, Masaryk University Hospital Brno, Central European Institute of Technology, Brno, Czech Republic.
authors: Jiří
authors: J
authors: Mayer
authors: Department of Hematology, Wrocław Medical University, Wrocław, Poland.
authors: Grzegorz
authors: G
authors: Mazur
authors: Department of Hematology, Edouard Herriot Hospital, Lyon, France.
authors: Xavier
authors: X
authors: Thomas
authors: Copernicus Memorial Hospital, Lodz, Poland.
authors: Agnieszka
authors: A
authors: Wierzbowska
authors: Oncology Product Creation Unit, Eisai Inc., Woodcliff Lake, NJ, USA.
authors: Mark M
authors: MM
authors: Jones
authors: Oncology Product Creation Unit, Eisai Inc., Woodcliff Lake, NJ, USA.
authors: Erhan
authors: E
authors: Berrak
authors: Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors: Hagop
authors: H
authors: Kantarjian
keywords: acute myeloid leukemia; adult; decitabine; leukemia; prognosis