title: Efficacy of single-agent decitabine in relapsed and refractory acute myeloid leukemia.
abstract: Improving therapy for relapsed/refractory AML remains a challenge. We performed a retrospective analysis of outcomes following decitabine treatment in 34 patients with relapsed/refractory AML (median age, 62; median Charlson comorbidity score, 6). Decitabine, 20 mg/m2daily, was given in 5- (25%) or 10-day (75%) cycles. Overall response rate (OR) was 30% with 21% complete remission and 9% partial remission rate. Patients with therapy-related myeloid neoplasm (t-MN) and secondary AML had a significantly higher OR compared to those with de novo AML (70 vs. 30%; p = .02). Median overall survival of all patients was 8.5 months. Median survival in patients with t-MN or secondary AML was 12.4 months compared to 8 months in those with de novo AML (p = .20). Fifteen (44%) patients proceeded to hematopoietic stem cell transplant. These data support using 10-day treatment cycles of decitabine in patients with relapsed/refractory AML, particularly for those with secondary or therapy-related AML.
authors.affiliation: a Departments of Medicine and Pediatrics , The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Niloufer
authors.initials: N
authors.lastname: Khan
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hantel
authors.affiliation: c Department of Pharmacy , The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Randall W
authors.initials: RW
authors.lastname: Knoebel
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Artz
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Larson
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Godley
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thirman
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liu
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Churpek
authors.affiliation: d Department of Medicine , Section of Hematology/Oncology, The University of Michigan , Ann Arbor , MI , USA.
authors.forename: Darren
authors.initials: D
authors.lastname: King
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Olatoyosi
authors.initials: O
authors.lastname: Odenike
authors.affiliation: b Department of Medicine , Section of Hematology/Oncology, The University of Chicago Medicine , Chicago , IL , USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Stock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001374:Azacitidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D000077209:Decitabine; D019008:Drug Resistance, Neoplasm; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D053208:Kaplan-Meier Estimate; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000964:Antimetabolites, Antineoplastic; D000077209:Decitabine; D001374:Azacitidine
keywords: AML; Decitabine; acute myeloid leukemia; refractory AML; relapsed AML