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Delivering HDAC over 3 or 5 days as consolidation in AML impacts health care resource consumption but not outcome
- Source :
- Blood Adv
- Publication Year :
- 2020
- Publisher :
- American Society of Hematology, 2020.
-
Abstract
- Postremission treatment is crucial to prevent relapse in acute myeloid leukemia (AML). High-dose cytarabine delivered every 12 hours on days 1, 3, and 5 (HDAC-135) is the standard of care for younger adult patients with AML. Although this standard has been unsuccessfully challenged by other treatment regimens, including multiagent chemotherapy, the timing of HDAC administration has attracted little attention. Here, we retrospectively compared the safety, efficacy, and health care resource consumption associated with HDAC-135 and another standard, condensed HDAC-123 regimen, as consolidation treatment in younger AML patients in first complete response. This study included 221 patients (median age, 46.6 years; range, 18-60 years). HDAC-123 and HDAC-135 were used in 92 and 129 patients, respectively. Both regimens were associated with similar rates of relapse-free survival, cumulative incidence of relapse, nonrelapse mortality, and overall survival, including in core binding factor AML subgroup in which levels of minimal residual disease reduction were similar in both schedules. Hematological recovery times regarding neutrophils and platelets were significantly shorter in patients receiving HDAC-123, with an average difference of 3 to 4 days for each consolidation cycle. The total duration of hospitalization for the whole postremission program was shorter with HDAC-123 (32 days; interquartile ratio [IQR], 22.0,36.5) compared with HDAC-135 (41 days; IQR, 30.5, 50.0) (P < .0001). In conclusion, the condensed HDAC-123 regimen induced faster hematological recovery and therefore significantly reduced the length of hospital stay without affecting treatment response or outcome in younger AML patients.
- Subjects :
- Adult
medicine.medical_specialty
Myeloid
Disease-Free Survival
Interquartile range
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Cumulative incidence
Retrospective Studies
Myeloid Neoplasia
business.industry
Retrospective cohort study
Hematology
Middle Aged
medicine.disease
Minimal residual disease
Leukemia, Myeloid, Acute
Leukemia
Regimen
medicine.anatomical_structure
Cytarabine
business
Delivery of Health Care
medicine.drug
Subjects
Details
- ISSN :
- 24739537 and 24739529
- Volume :
- 4
- Database :
- OpenAIRE
- Journal :
- Blood Advances
- Accession number :
- edsair.doi.dedup.....253f7d8ea4a51e48becc42f9357e6be0