PMID- 20026804
OWN - NLM
STAT- MEDLINE
DCOM- 20100218
LR  - 20220311
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Linking)
VI  - 28
IP  - 4
DP  - 2010 Feb 1
TI  - Azacitidine prolongs overall survival compared with conventional care regimens in 
      elderly patients with low bone marrow blast count acute myeloid leukemia.
PG  - 562-9
LID - 10.1200/JCO.2009.23.8329 [doi]
AB  - PURPOSE: In a phase III randomized trial, azacitidine significantly prolonged 
      overall survival (OS) compared with conventional care regimens (CCRs) in patients 
      with intermediate-2- and high-risk myelodysplastic syndromes. Approximately one 
      third of these patients were classified as having acute myeloid leukemia (AML) 
      under current WHO criteria. This analysis compared the effects of azacitidine 
      versus CCR on OS in this subgroup. PATIENTS AND METHODS: Patients were randomly 
      assigned to receive subcutaneous azacitidine 75 mg/m(2)/d or CCR (best supportive 
      care [BSC] only, low-dose cytarabine (LDAC), or intensive chemotherapy [IC]). 
      RESULTS: Of the 113 elderly patients (median age, 70 years) randomly assigned to 
      receive azacitidine (n = 55) or CCR (n = 58; 47% BSC, 34% LDAC, 19% IC), 86% were 
      considered unfit for IC. At a median follow-up of 20.1 months, median OS for 
      azacitidine-treated patients was 24.5 months compared with 16.0 months for 
      CCR-treated patients (hazard ratio = 0.47; 95% CI, 0.28 to 0.79; P = .005), and 
      2-year OS rates were 50% and 16%, respectively (P = .001). Two-year OS rates were 
      higher with azacitidine versus CCR in patients considered unfit for IC (P = 
      .0003). Azacitidine was associated with fewer total days in hospital (P < .0001) 
      than CCR. CONCLUSION: In older adult patients with low marrow blast count (20% to 
      30%) WHO-defined AML, azacitidine significantly prolongs OS and significantly 
      improves several patient morbidity measures compared with CCR.
FAU - Fenaux, Pierre
AU  - Fenaux P
AD  - Service d'Hematologie Clinique, Hospital Avicenne, Assistance Publique-Hopitaux 
      de Paris (AP-HP), Universite Paris XIII, Bobigny, France. 
      pierre.fenaux@avc.aphp.fr
FAU - Mufti, Ghulam J
AU  - Mufti GJ
FAU - Hellstrom-Lindberg, Eva
AU  - Hellstrom-Lindberg E
FAU - Santini, Valeria
AU  - Santini V
FAU - Gattermann, Norbert
AU  - Gattermann N
FAU - Germing, Ulrich
AU  - Germing U
FAU - Sanz, Guillermo
AU  - Sanz G
FAU - List, Alan F
AU  - List AF
FAU - Gore, Steven
AU  - Gore S
FAU - Seymour, John F
AU  - Seymour JF
FAU - Dombret, Herve
AU  - Dombret H
FAU - Backstrom, Jay
AU  - Backstrom J
FAU - Zimmerman, Linda
AU  - Zimmerman L
FAU - McKenzie, David
AU  - McKenzie D
FAU - Beach, C L
AU  - Beach CL
FAU - Silverman, Lewis R
AU  - Silverman LR
LA  - eng
PT  - Clinical Trial, Phase III
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20091221
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Antimetabolites, Antineoplastic)
RN  - M801H13NRU (Azacitidine)
SB  - IM
CIN - J Clin Oncol. 2010 Feb 1;28(4):521-3. PMID: 20026796
CIN - J Clin Oncol. 2010 Aug 1;28(22):e380-1. PMID: 20458054
MH  - Aged
MH  - Aged, 80 and over
MH  - Antimetabolites, Antineoplastic/*therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Azacitidine/*therapeutic use
MH  - Blast Crisis/*pathology
MH  - Bone Marrow Cells/*pathology
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - International Agencies
MH  - Leukemia, Myeloid, Acute/*drug therapy/*mortality
MH  - Leukocyte Count
MH  - Male
MH  - Maximum Tolerated Dose
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2009/12/23 06:00
MHDA- 2010/02/19 06:00
CRDT- 2009/12/23 06:00
PHST- 2009/12/23 06:00 [entrez]
PHST- 2009/12/23 06:00 [pubmed]
PHST- 2010/02/19 06:00 [medline]
AID - JCO.2009.23.8329 [pii]
AID - 10.1200/JCO.2009.23.8329 [doi]
PST - ppublish
SO  - J Clin Oncol. 2010 Feb 1;28(4):562-9. doi: 10.1200/JCO.2009.23.8329. Epub 2009 
      Dec 21.