A phase II study of timed sequential therapy of acute myelogenous leukemia (AML) for patients over the age of 60: Two cycle timed sequential therapy with topotecan, ara-C and mitoxantrone in adults with poor-risk AML

Research output: Contribution to journalArticle

Abstract

Acute myeloid leukemia (AML) in the elderly is a serious problem characterized by poor response to therapy and short survival. To improve response to therapy, a timed sequential therapy (TST) approach was designed utilizing topotecan, cytosine arabinoside (ara-C) and mitoxantrone based on multiple studies suggesting that topotecan and mitoxantrone are effective in older patients. Thirty-two adults, ≥60-year-old (median age 69) were included. None had favorable cytogenetics and 44% had and antecedent myelodysplastic syndrome (MDS) or 2° AML. Fifty-nine percent achieved a complete response (CR). Median overall survival (OS) was 6.5 months (95% confidence interval (CI): 3.1-12.0 months; range, 15 days to 25.3 months). Disease-free survival (DFS) for the 19 patients achieving a CR was 7.7 months (95% CI: 6.1-13.7 months; range, 2.9-25.3 months). There were no differences in OS or DFS between cytogenetic or disease etiology groups. Although TST was well tolerated, long-term results in this group of patients are not satisfactory and new approaches are needed.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalLeukemia Research
Volume28
Issue number6
DOIs
StatePublished - Jun 1 2004

Keywords

  • 2° AML
  • AML
  • Acute myeloid leukemia
  • CI
  • CR
  • Complete response
  • Confidence interval
  • DFS
  • Disease-free survival
  • MDS
  • Myelodysplastic syndrome
  • NR
  • OS
  • Overall survival
  • Secondary (treatment related) acute myeloid leukemia
  • TST
  • Timed sequential therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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