The Role of Azacitidine in the Treatment of Elderly Patients with Acute Myeloid Leukemia: Results of a Retrospective Multicenter Study.
OBJECTIVE
In this study, we aimed to investigate the efficacy and safety of azacitidine (AZA) in elderly patients with acute myeloid leukemia (AML), including patients with >30% bone marrow (BM) blasts.


METHODS
In this retrospective multicenter study, 130 patients of ≥60 years old who were ineligible for intensive chemotherapy or had progressed despite conventional treatment were included.


RESULTS
The median age was 73 years and 61.5% of patients had >30% BM blasts. Patients received AZA for a median of four cycles (range: 1-21). Initial overall response [including complete remission (CR)/CR with incomplete recovery/partial remission] was 36.2%. Hematologic improvement (HI) of any kind was documented in 37.7% of all patients. HI was also documented in 27.1% of patients who were unresponsive to treatment. Median overall survival (OS) was 18 months for responders and 12 months for nonresponders (p=0.005). In the unresponsive patient group, any HI improved OS compared to patients without any HI (median OS was 14 months versus 10 months, p=0.068). Eastern Cooperative Oncology Group performance status of <2, increasing number of AZA cycles (≥5 courses), and any HI predicted better OS. Age, AML type, and BM blast percentage had no impact.


CONCLUSIONS
We conclude that AZA is effective and well tolerated in elderly comorbid AML patients, irrespective of BM blast count, and HI should be considered a sufficient response to continue treatment with AZA.
Mersin University Faculty of Medicine, Department of Hematology, Mersin, Turkey, Phone: +90 532 346 07 67, E-mail: aniltombak@mersin.edu.tr.
Anıl
A
Tombak
Mehmet Ali
MA
Uçar
Aydan
A
Akdeniz
Eyüp Naci
EN
Tiftik
Deniz
D
Gören Şahin
Olga Meltem
OM
Akay
Murat
M
Yıldırım
Oral
O
Nevruz
Cem
C
Kis
Emel
E
Gürkan
Şerife Medeni
ŞM
Solmaz
Mehmet Ali
MA
Özcan
Rahşan
R
Yıldırım
İlhami
İ
Berber
Mehmet Ali
MA
Erkurt
Tülin
T
Fıratlı Tuğlular
Pınar
P
Tarkun
İrfan
İ
Yavaşoğlu
Mehmet Hilmi
MH
Doğu
İsmail
İ
Sarı
Mustafa
M
Merter
Muhit
M
Özcan
Esra
E
Yıldızhan
Leylagül
L
Kaynar
Özgür
Ö
Mehtap
Ayşe
A
Uysal
Fahri
F
Şahin
Ozan
O
Salim
Mehmet Ali
MA
Sungur
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001374:Azacitidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers; D001853:Bone Marrow / Q000473:pathology; D015897:Comorbidity; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D015415:Biomarkers; D001374:Azacitidine