Department of Medicine, Loyola University Medical Center, Maywood, IL;
Blood. 2013 Nov 14;122(20):3432-9. doi: 10.1182/blood-2013-06-506592. Epub 2013 Oct 3.
This trial tested the safety and efficacy of a regimen consisting of hydroxyurea followed by azacitidine, 75 mg/m(2) for 7 days, and gemtuzumab ozogamicin, 3 mg/m(2) on day 8, in older patients with newly diagnosed acute myeloid leukemia. Those achieving a complete remission received 1 consolidation treatment followed by 4 cycles of azacitidine. The patients were stratified into good-risk (age 60-69 years or performance status 0-1) and poor-risk (age ≥70 years and performance status 2 or 3) groups. Specific efficacy and safety goals were defined as being supportive of further study of the regimen. Eighty-three patients were registered in the good-risk cohort and 59 in poor-risk cohort, with median age of 71 and 75 years, respectively. In the good-risk group, 35 patients (44%) achieved a complete remission. Median relapse-free and overall survivals were 8 and 11 months, respectively. Six patients (8%) died within 30 days of registration. In the poor-risk group, 19 (35%) achieved a complete remission. Median relapse-free and overall survivals were 7 and 11 months, respectively. Seven patients (14%) died early. The results of this trial met predefined goals for efficacy and safety for the poor-risk cohort but not the good-risk group. .
这项试验旨在测试羟基脲联合阿扎胞苷(75mg/m2,连用 7 天)和吉妥珠单抗奥佐米星(3mg/m2,第 8 天)方案在新诊断的老年急性髓系白血病患者中的安全性和疗效。完全缓解的患者接受 1 次巩固治疗,随后接受 4 个周期的阿扎胞苷治疗。患者分为低危组(年龄 60-69 岁或体能状态 0-1 分)和高危组(年龄≥70 岁和体能状态 2 或 3 分)。具体的疗效和安全性目标是支持进一步研究该方案。83 例患者入组低危组,59 例患者入组高危组,中位年龄分别为 71 岁和 75 岁。在低危组中,35 例患者(44%)达到完全缓解。中位无复发生存期和总生存期分别为 8 个月和 11 个月。6 例患者(8%)在注册后 30 天内死亡。在高危组中,19 例患者(35%)达到完全缓解。中位无复发生存期和总生存期分别为 7 个月和 11 个月。7 例患者(14%)早期死亡。该试验的结果达到了高危组疗效和安全性的预设目标,但未达到低危组的目标。