A comparison of clofarabine with ara-C, each in combination with daunorubicin as induction treatment in older patients with acute myeloid ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-02

AUTHORS

A K Burnett, N H Russell, R K Hills, J Kell, O J Nielsen, M Dennis, P Cahalin, C Pocock, S Ali, S Burns, S Freeman, D Milligan, R E Clark

ABSTRACT

The study was designed to compare clofarabine plus daunorubicin vs daunorubicin/ara-C in older patients with acute myeloid leukaemia (AML) or high-risk myelodysplastic syndrome (MDS). Eight hundred and six untreated patients in the UK NCRI AML16 trial with AML/high-risk MDS (median age, 67 years; range 56-84) and normal serum creatinine were randomised to two courses of induction chemotherapy with either daunorubicin/ara-C (DA) or daunorubicin/clofarabine (DClo). Patients were also included in additional randomisations; ± one dose of gemtuzumab ozogamicin in course 1; 2v3 courses and ± azacitidine maintenance. The primary end point was overall survival. The overall response rate was 69% (complete remission (CR) 60%; CRi 9%), with no difference between DA (71%) and DClo (66%). There was no difference in 30-/60-day mortality or toxicity: significantly more supportive care was required in the DA arm even though platelet and neutrophil recovery was significantly slower with DClo. There were no differences in cumulative incidence of relapse (74% vs 68%; hazard ratio (HR) 0.93 (0.77-1.14), P=0.5); survival from relapse (7% vs 9%; HR 0.96 (0.77-1.19), P=0.7); relapse-free (31% vs 32%; HR 1.02 (0.83-1.24), P=0.9) or overall survival (23% vs 22%; HR 1.08 (0.93-1.26), P=0.3). Clofarabine 20 mg/m2 given for 5 days with daunorubicin is not superior to ara-C+daunorubicin as induction for older patients with AML/high-risk MDS. More... »

PAGES

310

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/leu.2016.225

DOI

http://dx.doi.org/10.1038/leu.2016.225

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1023885427

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27624670


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RDF/XML is a standard XML format for linked data.

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323 https://www.grid.ac/institutes/grid.415149.c schema:alternateName Kent and Canterbury Hospital
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326 https://www.grid.ac/institutes/grid.415720.5 schema:alternateName The Christie Hospital
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335 https://www.grid.ac/institutes/grid.5600.3 schema:alternateName Cardiff University
336 schema:name Centre for Trails Research, Cardiff University, Cardiff, UK
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339 https://www.grid.ac/institutes/grid.6572.6 schema:alternateName University of Birmingham
340 schema:name Department of Immunology, University of Birmingham, Birmingham, UK
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