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Leuk Lymphoma. 2018 May;59(5):1113-1120. doi: 10.1080/10428194.2017.1365854. Epub 2017 Aug 24.

Real life experience with frontline azacitidine in a large series of older adults with acute myeloid leukemia stratified by MRC/LRF score: results from the expanded international E-ALMA series (E-ALMA+).

Author information

1
a Department of Hematology , University Hospital Virgen del Rocío , Seville , Spain.
2
b 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research , Oncologic Center, Paracelsus Medical University Hospital Salzburg , Salzburg , Austria.
3
c Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials , Salzburg , Austria.
4
d Cancer Cluster Salzburg , Salzburg , Austria.
5
e Department of Blood Diseases/Hematology , CHU Angers , Angers , France.
6
f Department of Hematology , Instituto Português de Oncologia Francisco Gentil , Lisbon , Portugal.
7
g Department of Hematology , Tor Vergata Foundation Polyclinic, University of Rome , Rome , Italy.
8
h Department of Hematology , University Hospital , León , Spain.
9
i Department of Internal Medicine V (Hematology and Oncology) , Innsbruck Medical University , Innsbruck , Austria.
10
j Department of Hematology , Saint Louis Hospital, Paris VII University (APHP) , Paris , France.
11
k Department of Hematology , Hospital São João , Porto , Portugal.
12
l Department of Hematology , Son Llatzer Hospital , Palma de Mallorca , Spain.
13
m Department of Internal Medicine IV , Wels-Grieskirchen Hospital , Wels , Austria.
14
n Department of Hematology , Doce de Octubre University Hospital , Madrid , Spain.
15
o Department of Hematology , Avicenne Hospital, Paris XIII University (APHP) , Bobigny , France.
16
p Department of Hematology , Centro Hospitalar Universitário de Coimbra , Coimbra , Portugal.
17
q Department of Hematology , Infanta Leonor University Hospital , Madrid , Spain.
18
r Department of Hematology , La Fe University Hospital , Valencia , Spain.
19
s Scientific Direction, IRCCS-CROB Referral Cancer Center of Basilicata , Rionero in Vulture , Italy.
20
t Institute of Biomedicine , University of León , León , Spain.

Abstract

Azacitidine (AZA) prolonged overall survival (OS) in the AZA-AML-001 trial. However, few subjects were randomized to AZA or intensive chemotherapy (IC). The Medical Research Council (MRC) and the Leukemia Research Foundation (LRF) developed a score for older AML patients receiving IC or non-intensive regimens, whereas the E-ALMA study validated a score for survival and response in elderly patients receiving AZA in daily practice. Both identified three groups with different risk estimates. This analysis evaluates the efficacy of frontline AZA in older AML patients (N = 710) unfit for IC from different national registries (E-ALMA + series) stratified by the MRC/LRF risk score. Median OS of patients categorized as good, standard and poor-risk groups by the MRC/LRF score was 13.4 (95% CI, 10.8-16), 12.4 (95% CI, 9.9-14.8), and 8.1 months (95% CI, 7-9.1), respectively (p = .0001). In conclusion, this is the largest retrospective cohort of older AML patients treated with AZA.

KEYWORDS:

Acute myeloid leukemia; E-ALMA+; MRC/LRF risk score; azacitidine; elderly

PMID:
28838276
DOI:
10.1080/10428194.2017.1365854
[Indexed for MEDLINE]

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