Publication details

Multivariate and subgroup analyses of a randomized, multinational, phase 3 trial of decitabine vs treatment choice of supportive care or cytarabine in older patients with newly diagnosed acute myeloid leukemia and poor- or intermediate-risk cytogenetics

Authors

MAYER Jiří ARTHUR Christopher DELAUNAY Jacques MAZUR Grzegorz THOMAS Xavier G. WIERZBOWSKA Agnieszka RAVANDI Farhad BERRAK Erhan JONES Mark LI Yuhan KANTARJIAN Hagop M.

Year of publication 2014
Type Article in Periodical
Magazine / Source BMC Cancer
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1186/1471-2407-14-69
Field Oncology and hematology
Keywords Decitabine; Acute Myelocytic Leukemia; Elderly; Treatment
Attached files
Description Background Compared with younger patients, older adults with acute myeloid leukemia (AML) generally have poorer survival outcomes and less benefit from clinical trials. A recent phase 3 trial demonstrated a trend toward improved overall survival (OS) with decitabine, a hypomethylating agent, compared with treatment choice of either cytarabine or supportive care (7.7 months, 95% CI: 6.2-9.2 vs 5.0 months, 95% CI: 4.3-6.3, respectively) in older adults with newly diagnosed AML. The current analyses investigated prognostic factors for outcomes in this trial and examined OS and responses in prespecified subgroups. Methods A multivariate Cox proportional hazards model was used to investigate effects of demographic and baseline characteristics, including age, sex, cytogenetic risk, AML type, ECOG Performance Status, geographic region, bone marrow blasts, platelets, and white blood cells on OS, based on mature data. Similar analyses were conducted with a logistic regression model to predict response rates. Prespecified subgroup analyses were performed for OS and response rates, also using mature data. Conclusion Response to decitabine in AML is associated with known prognostic factors related to both patient demographics and disease characteristics.

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