The Role of Azacitidine in the Treatment of Elderly Patients with Acute

Abstract

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.

Materials and 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.

Conclusion: 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.

C1 [Tombak, Anil; Ucar, Mehmet Ali; Akdeniz, Aydan; Tiftik, Eyup Naci] Mersin Univ, Dept Hematol, Fac Med, Mersin, Turkey.

[Sahin, Deniz Goren; Akay, Olga Meltem] Osmangazi Univ, Dept Hematol, Fac Med, Eskisehir, Turkey.

[Yildirim, Murat; Nevruz, Oral] Gulhane Training & Res Hosp, Clin Hematol, Ankara, Turkey.

[Kis, Cem; Gurkan, Emel] Cukurova Univ, Dept Hematol, Fac Med, Adana, Turkey.

[Solmaz, Serife Medeni; Ozcan, Mehmet Ali] Dokuz Eylul Univ, Dept Hematol, Fac Med, Izmir, Turkey.

[Yildirim, Rahsan] Ataturk Univ, Fac Med, Dept Hematol, Erzurum, Turkey.

[Berber, Ilhami; Erkurt, Mehmet Ali] Inonu Univ, Fac Med, Dept Hematol, Malatya, Turkey.

[Tuglular, Tulin Firatli] Marmara Univ, Dept Hematol, Fac Med, Istanbul, Turkey.

[Tarkun, Pinar; Mehtap, Ozgur] Kocaeli Univ, Dept Hematol, Fac Med, Kocaeli, Turkey.

[Yavasoglu, Irfan] Adnan Menderes Univ, Dept Hematol, Fac Med, Aydin, Turkey.

[Dogu, Mehmet Hilmi; Sari, Ismail] Pamukkale Univ, Dept Hematol, Fac Med, Denizli, Turkey.

[Merter, Mustafa; Ozcan, Muhit] Ankara Univ, Dept Hematol, Fac Med, Ankara, Turkey.

[Yildizhan, Esra; Kaynar, Leylagul] Erciyes Univ, Dept Hematol, Fac Med, Kayseri, Turkey.

[Uysal, Ayse; Sahin, Fahri] Ege Univ, Dept Hematol, Fac Med, Izmir, Turkey.

[Salim, Ozan] Akdeniz Univ, Dept Hematol, Fac Med, Antalya, Turkey.

[Sungur, Mehmet Ali] Duzce Univ, Dept Biostat, Fac Med, Duzce, Turkey.