Treatment of Acute Myeloid Leukaemia

Cancer research · Acute myeloid leukemia

Treatment with decitabine resulted in a similar survival and fewer adverse events compared with conventional chemotherapy in older fit patients with acute myeloid leukaemia.

In a phase III randomized controlled trial (EORTC‑1301‑LG‑AML21, NCT02172872), 606 patients aged 60 or older who were fit for intensive chemotherapy were randomized to receive either a 10‑day decitabine monotherapy schedule or the standard 3+7 intensive chemotherapy regimen. The trial demonstrated no difference in overall survival (HR 1.04, 95% CI 0.86–1.26, p = 0.68) and showed a lower incidence of severe adverse events in the decitabine arm, including fewer severe infections (41% vs 53%), oral mucositis (2% vs 10%) and diarrhea (1% vs 8%). Both arms achieved comparable rates of allogeneic hematopoietic cell transplantation. These findings support decitabine as a viable backbone for AML treatment in older, fit patients.

Decitabine offers a less toxic alternative to intensive chemotherapy for older patients who might otherwise be unable to tolerate standard regimens, improving tolerability without compromising survival and potentially facilitating subsequent curative transplantation.

Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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