TY - JOUR
T1 - Azacitidine frontline therapy for unfit acute myeloid leukemia patients
T2 - Clinical use and outcome prediction
AU - The European ALMA Investigators
AU - Ramos, F.
AU - Thépot, S.
AU - Pleyer, L.
AU - Maurillo, L.
AU - Itzykson, R.
AU - Bargay, J.
AU - Stauder, R.
AU - Venditti, A.
AU - Seegers, V.
AU - Martínez-Robles, V.
AU - Burgstaller, S.
AU - Récher, C.
AU - Debén, G.
AU - Gaidano, G.
AU - Gardin, C.
AU - Musto, P.
AU - Greil, R.
AU - Sánchez-Guijo, Fermín
AU - Fenaux, P.
AU - Thépot, Sylvain
AU - Récher, Christian
AU - Raffoux, Emmanuel
AU - Quesnel, Bruno
AU - Delaunay, Jacques
AU - Cluzeau, Thomas
AU - Koka, Anne Marfaing
AU - Stamatoullas, Aspasia
AU - Chaury, Marie Pierre
AU - Gyan, Emmanuel
AU - Cheze, Stéphane
AU - Banos, Anne
AU - Morel, Pierre
AU - Plantier, Isabelle
AU - Taksin, Anne Laure
AU - Shanti, Ame
AU - Sanhes, Laurence
AU - De Botton, Stephane
AU - Marolleau, Jean Pierre
AU - Pautas, Cécile
AU - Wattel, Eric
AU - Isnard, Francoise
AU - Guerci, Agnies
AU - Vey, Norbert
AU - Dreyfus, Francois
AU - Ifrah, Norbert
AU - Ades, Lionel
AU - Martínez-Robles, Violeta
AU - Debén, Guillermo
AU - Garrido, Ana
AU - Casaño, Javier
N1 - Publisher Copyright:
© 2014 Elsevier Ltd.
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Hypomethylating agents are able to prolong the overall survival of some patients diagnosed with acute myeloid leukemia. The aim of this study was to evaluate the clinical use of azacitidine as front-line therapy in unfit acute myeloid leukemia (AML) patients and to develop a clinical prediction model to identify which patients may benefit more from the drug. One hundred and ten untreated unfit AML patients received front-line azacitidine therapy in Spain, and response and survival were evaluated in them following European LeukemiaNet (ELN) guidelines. A clinical prediction rule was obtained from this population that was validated and refined in 261 patients treated in France, Austria and Italy. ELN response was achieved in 21.0% of the 371 patients (CI95% 17.0-25.5) and did not depend on bone marrow blast cell percentage. Median overall survival was 9.6 months (CI95% 8.5-10.8) and 40.6% of the patients were alive at 1 year (CI95% 35.5-45.7). European ALMA score (E-ALMA), based on performance status, white blood cell counts at azacitidine onset and cytogenetics, discriminated three risk groups with different survival and response rates. Azacitidine seems a reasonable therapeutic option for most unfit AML patients, i.e. those displaying a favorable or intermediate E-ALMA score.
AB - Hypomethylating agents are able to prolong the overall survival of some patients diagnosed with acute myeloid leukemia. The aim of this study was to evaluate the clinical use of azacitidine as front-line therapy in unfit acute myeloid leukemia (AML) patients and to develop a clinical prediction model to identify which patients may benefit more from the drug. One hundred and ten untreated unfit AML patients received front-line azacitidine therapy in Spain, and response and survival were evaluated in them following European LeukemiaNet (ELN) guidelines. A clinical prediction rule was obtained from this population that was validated and refined in 261 patients treated in France, Austria and Italy. ELN response was achieved in 21.0% of the 371 patients (CI95% 17.0-25.5) and did not depend on bone marrow blast cell percentage. Median overall survival was 9.6 months (CI95% 8.5-10.8) and 40.6% of the patients were alive at 1 year (CI95% 35.5-45.7). European ALMA score (E-ALMA), based on performance status, white blood cell counts at azacitidine onset and cytogenetics, discriminated three risk groups with different survival and response rates. Azacitidine seems a reasonable therapeutic option for most unfit AML patients, i.e. those displaying a favorable or intermediate E-ALMA score.
KW - Acute myeloid leukemia
KW - Azacitidine
KW - Elderly
KW - Prediction
KW - Score
KW - Unfit
UR - http://www.scopus.com/inward/record.url?scp=84924076153&partnerID=8YFLogxK
U2 - 10.1016/j.leukres.2014.12.013
DO - 10.1016/j.leukres.2014.12.013
M3 - Article
C2 - 25601157
AN - SCOPUS:84924076153
SN - 0145-2126
VL - 39
SP - 296
EP - 306
JO - Leukemia Research
JF - Leukemia Research
IS - 3
ER -