Azacitidine for the treatment of patients with acute myeloid leukemia with 20%-30% blasts and multilineage dysplasia

被引:7
作者
Font P. [1 ]
机构
[1] Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid
关键词
Acute myeloid leukemia; Azacitidine; Myelodysplastic syndromes;
D O I
10.1007/s12325-011-0002-8
中图分类号
学科分类号
摘要
Azacitidine is approved in the EU for the treatment of adult patients who are not candidates for allogeneic stem cell transplantation, and who have intermediate-2 risk or high-risk myelodysplastic syndromes, according to the International Prognostic Scoring System. The approval includes the treatment of patients with acute myeloid leukemia (AML) with 20%-30% blasts and multilineage dysplasia, according to the World Health Organization (WHO) classification. This review focuses on the outcomes with azacitidine in this latter group of patients, previously classified as refractory anemia with excess of blasts in transformation, as defined by the French-American-British classification criteria. The main clinical evidence is based on the results of two large phase III clinical trials (Cancer and Leukemia Group B 9221, and AZA-001). The AZA-001 trial shows azacitidine significantly prolongs median overall survival in older patients with low marrow blasts (20%-30%) according to WHO-defined AML, and significantly improved several patient morbidity measures, compared with conventional care regimens. In addition, the review examines the results of azacitidine in combination with other treatments currently used in AML. © Springer Healthcare 2011.
引用
收藏
页码:1 / 9
页数:8
相关论文
共 33 条
[1]  
Silverman L.R., Targeting hypomethylation of DNA to achieve cellular differentiation in myelodysplastic syndromes (MDS), Oncologist, 6, SUPPL. 5, pp. 8-14, (2001)
[2]  
Leone G., Teofili L., Voso M.T., Lubbert M., DNA methylation and demethylating drugs in myelodysplastic syndromes and secondary leukemias, Haematologica, 87, 12, pp. 1324-1341, (2002)
[3]  
Greenberg P., Cox C., LeBeau M.M., Fenaux P., Morel P., Sanz G., Sanz M., Vallespi T., Hamblin T., Oscier D., Ohyashiki K., Toyama K., Aul C., Mufti G., Bennett J., International scoring system for evaluating prognosis in myelodysplastic syndromes, Blood, 89, 6, pp. 2079-2088, (1997)
[4]  
Vardiman J.W., Harris N.L., Brunning R.D., The World Health Organization (WHO) classification of the myeloid neoplasms, Blood, 100, pp. 2292-2302, (2002)
[5]  
Vidaza® EPAR-Product Information
[6]  
Fenaux P., Mufti G., Hellstrom-Lindberg E., Et al., Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: A randomised, open-label, phase III study, Lancet Oncol, 10, pp. 223-232, (2009)
[7]  
NCCN Clinical Practice Guidelines in Oncology. Acute Myeloid Leukemia
[8]  
Appelbaum F., Gundacker H., Head D., Et al., Age and acute myeloid leukemia, Blood, 107, pp. 3481-3485, (2006)
[9]  
Kantarjian H., O'Brien S., Cortes J., Et al., Results of intensive chemotherapy in 998 patients age 65 years or older with acute myeloid leukemia or high-risk myelodysplastic syndrome: Predictive prognostic models for outcome, Cancer, 106, pp. 1090-1098, (2006)
[10]  
Deschler B., De Witte T., Mertelsmann R., Lubbert M., Treatment decision-making for older patients with high-risk myelodysplastic syndrome or acute myeloid leukemia: Problems and approaches, Haematologica, 91, 11, pp. 1513-1522, (2006)