Publication Date:
2020-11-05
Description:
Introduction: Decitabine and azacitidine have been increasingly used to treat patients with acute myeloid leukemia (AML) who are elderly or not suitable for intensive chemotherapy. Despite their widespread use, there is no consensus on their efficacy, with considerable variability between studies. Furthermore, they have not been directly compared in a randomized clinical trial. Our aim was to analyze and compare the efficacy of azacitidine and decitabine for the treatment of AML in elderly patients and/or patients not suitable for intensive chemotherapy. Methods: We included randomized controlled trials and retrospective studies enrolling adults diagnosed with newly diagnosed AML and treated with azacitidine or decitabine, not eligible for intensive chemotherapy. Only data from azacitidine or decitabine monotherapy arms were included. We included studies that reported at least one of the following outcomes: mortality, overall survival (OS), complete remission (CR), complete remission with incomplete hematologic recovery (CRi), partial response (PR). Results: The search strategy revealed 681 citations, before the duplicates were removed. Finally, 20 articles were included after analysis of abstracts and full text. In total, 23 patient cohorts were analysed (12 for azacitidine and 11 for decitabine). Table 1 shows the results of response, OS and 1-year mortality during azacitidine (75mg/m2 for 7d and 5d) and decitabine (20 mg/m2 for 5d and 10d) treatment. Comparing only the standard regimens, the overall response rate (ORR=CR+RCi+RP) for azacitidine (75 mg/m2, 7d) was 30% (95% CI 23%-37%) and for decitabine (20mg/m2, 5d) was 46% (95% CI 42%-50%), p75%), and the result was significantly different between azacitidine (51% mortality, 95%CI: 46% -57%) and decitabine (72% mortality, 95%CI: 67% -76%), p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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