Prolonged administration of low-dose cytarabine and thioguanine in elderly patients with acute myeloid leukaemia (AML) achieves high complete remission rates and prolonged survival

Christopher Arthur, Anthony Jeffrey, Eva Yip, Vicki Katsioulas, Anastasios Nalpantidis, Ian Kerridge, Matthew Greenwood, Luke Coyle, Naomi Mackinlay, Keith Fay, Anoop Enjeti, Jake Shortt, William Stevenson

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Abstract

The prognosis of AML in elderly patients is poor and research into novel therapeutic approaches is urgently needed. This study examined the use of low-dose chemotherapy with cytarabine and thioguanine administered in repetitive cycles in 62 elderly patients with newly diagnosed or relapsed/refractory AML. The overall response rate was 58% in the total cohort. Response rates (CR/CRi) were significantly higher in patients with newly diagnosed AML (74%) compared to patients with relapsed/refractory disease (25%, p =.0004). Kaplan–Meier estimate of overall survival was 289 days (95% CI; 183–395 days) with a relapse rate of 65.7%. The induction mortality rate was 16.1% with treatment successfully undertaken in the outpatient setting. Similar clinical outcomes were observed in a retrospective analysis of a second cohort of 25 AML patients treated at a different site. These results support the use of a sustained low intensity chemotherapy approach as a therapeutic option for elderly patients with AML.

Original languageEnglish
Pages (from-to)831-839
Number of pages9
JournalLeukemia and Lymphoma
Volume61
Issue number4
DOIs
Publication statusPublished - 20 Mar 2020

Keywords

  • acute myeloid leukemia
  • cytarabine
  • Low-dose chemotherapy
  • thioguanine

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