Hematologic improvement and response in elderly AML/RAEB patients treated with valproic acid and low-dose Ara-C

被引：32
作者：
Corsettia, M. T. [1 ]
Salvi, F. [1 ]
Perticone, S. [1 ]
Baraldi, A. [1 ]
De Paoli, L. [1 ]
Gatto, S. [1 ]
Pietrasanta, D. [1 ]
Pini, M. [1 ]
Primon, V. [1 ]
Zallio, F. [1 ]
Tonso, A. [2 ]
Alvaro, M. G. [3 ]
Ciravegna, G. [4 ]
Levis, A. [1 ]
机构：
[1] Azienda Osped SS Arrigo & Blagio & Cesare Arrigo, Div Hematol, I-15100 Alessandria, Italy
[2] Osped Inferm Biella, Div Med, Biella, Italy
[3] Azienda USI, Div Oncol, Valle Daosta, Italy
[4] Osped Cardinal Massaia, Div Oncol, Asti, Italy
来源：
LEUKEMIA RESEARCH | 2011年 / 35卷 / 08期
关键词：
Ara-C; Valproic acid; AML; RAEB; Elderly; CGA; CIRS; ADL; IADL; ACUTE MYELOID-LEUKEMIA; TRANS-RETINOIC ACID; HISTONE DEACETYLASE INHIBITOR; RISK MYELODYSPLASTIC SYNDROME; INTENSIVE CHEMOTHERAPY; OLDER PATIENTS; DIFFERENTIATION; COMBINATION; CYTARABINE; INCREASE;
D O I：
10.1016/j.leukres.2011.02.021
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
The histone deacetylase inhibitor (HDACi) valproic acid (VPA) has been shown to be active on acute myeloid leukemia (AML) and refractory anemia with excess of blasts (RAEB). Thirty-one elderly AML/RAEB patients (AML n = 25; RAEB n = 6) with a high rate of comorbidity were entered in a phase II study with low-dose cytarabine (Ara-C) and VPA. Fitness was evaluated by means of the Comprehensive Geriatric Assessment (CGA), including the Cumulative Illness Rating Scale (CIRS) score, the self-sufficiency scores of Activity of Daily Living (ADL) and Instrumental Activity of Daily Living (IADL). Eight patients obtained a lasting complete remission and 3 other patients obtained hematologic improvement for a total response rate of 35%. Five of 11 responding patients were relapsed or resistant after a previous treatment with Ara-C. Seven of 11 responding patients were assessed as frail at enrolment and/or had IADL impairment. Grades 3 and 4 toxicities were mainly hematological. Low-dose Ara-C and VPA is a relatively non-toxic combination with good therapeutic activity in elderly patients with AML/RAEB. This therapeutic approach represents an alternative treatment for patients who cannot undergo standard induction therapy. (C) 2011 Published by Elsevier Ltd.
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收藏
页码：991 / 997
页数：7
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