Τίτλος:
Addition of cyclosporin-A to chemotherapy in secondary (post-MDS) AML in
the elderly. A multicenter randomized trial of the Leukemia Working
Group of the Hellenic Society of Hematology
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
In elderly patients with secondary leukemia, poor therapeutic response
and low overall survival have been attributed mainly to age and to the
primary resistance of leukemic cells to chemotherapy. Modulation of
resistance has been attempted in different studies, but the results have
been contradictory. We conducted an open, randomized multicenter
clinical trial involving patients more than 60 years old with secondary
leukemia preceded by a myelodysplastic syndrome. The induction
chemotherapy regimen included idarubicin, cytarabine, and etoposide
(group A); randomization involved simultaneous administration of
cyclosporin-A per os (group B). Fifty-five patients were evaluated, 26
in group A and 29 in group B. Overall complete remission was achieved in
40% of the patients, 27% vs 52% in groups A and B, respectively
(p=0.01). Leukemia-free survival was more favorable in patients who
received cyclosporin-A, 12 vs 7 months for groups B and A, respectively
(p=0.03). In a follow up period of 30 months, 7 out of 55 patients
(13%) were alive, 4 of whom were in complete remission. Five out of the
7 alive patients were randomized in group B and had received
cyclosporin-A. Treatment failure was higher in group A [19 of 26
patients (73%)] than in group B with CsA [14 of 29 patients (48%)]
(p < 0.0001). Treatment-related toxicity/mortality was 13%. Modulation
of drug resistance by CsA in elderly people suffering from secondary
acute leukemia may improve the outcome of chemotherapy without
increasing drug toxicity and treatment-related mortality.
Συγγραφείς:
Matsouka, P
Pagoni, M
Zikos, P
Giannakoulas, N and
Apostolidis, I
Asprogeraka, T
Arvanitopoulou, E
Spanoudakis,
E
Kotsianidis, I
Tsatalas, K
Papaioannou, M
Marinakis, T
and Skandali, A
Viniou, N
Yataganas, X
Bakiri, M
Περιοδικό:
Annals of Hematology
Λέξεις-κλειδιά:
acute myeloid leukemia; secondary; elderly; resistance; cyclosporin-A
(CsA)
DOI:
10.1007/s00277-005-0066-0
