Treatment of Acute Myeloid Leukaemia

Rákkutatás · 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.

Bizonyítékszint: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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