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Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson.

Publication ,  Journal Article
Othus, M; Kantarjian, H; Petersdorf, S; Ravandi, F; Godwin, J; Cortes, J; Pierce, S; Erba, H; Faderl, S; Appelbaum, FR; Estey, E
Published in: Leukemia
February 2014

Less-intense remission induction regimens for adults with newly diagnosed acute myeloid leukemia (AML) aim to reduce treatment-related mortality (TRM), here defined as death within 4 weeks after starting induction therapy. This assumes that TRM rates are similar to the 15-20% observed 20 years ago. Herein we test this assumption. We examined TRM rates in 1409 patients treated on SWOG (Southwest Oncology Group) trials and 1942 patients treated at MD Anderson (MDA) from 1991 to 2009. Eighty-eight percent of SWOG patients received '3+7' or regimens of similar intensity while 92% of the MDA patients received ara-C at 1.5-2.0 g/m(2) daily × 3-5 days+other cytotoxic agents. We examined the relationship between time and TRM rates after accounting for other covariates. TRM rates between 1991 and 2009 decreased from 18-3% in SWOG and 16-4% at MDA. Multivariate analyses showed a significant decrease in TRM over time (P=0.001). The decrease in TRM was not limited to younger patients, those with a better performance status or a lower white blood cell count. Though our observations are limited to patients treated with intensive therapy at SWOG institutions and MDA, the decrease in TRM with time emphasizes the problem with historical controls and could be considered when selecting AML induction therapy.

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Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

February 2014

Volume

28

Issue

2

Start / End Page

289 / 292

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Retrospective Studies
  • Middle Aged
  • Leukemia, Myeloid, Acute
  • Induction Chemotherapy
  • Immunology
  • Humans
  • Antineoplastic Combined Chemotherapy Protocols
  • Aged, 80 and over
 

Citation

APA
Chicago
ICMJE
MLA
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Othus, M., Kantarjian, H., Petersdorf, S., Ravandi, F., Godwin, J., Cortes, J., … Estey, E. (2014). Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson. Leukemia, 28(2), 289–292. https://doi.org/10.1038/leu.2013.176
Othus, M., H. Kantarjian, S. Petersdorf, F. Ravandi, J. Godwin, J. Cortes, S. Pierce, et al. “Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson.Leukemia 28, no. 2 (February 2014): 289–92. https://doi.org/10.1038/leu.2013.176.
Othus M, Kantarjian H, Petersdorf S, Ravandi F, Godwin J, Cortes J, et al. Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson. Leukemia. 2014 Feb;28(2):289–92.
Othus, M., et al. “Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson.Leukemia, vol. 28, no. 2, Feb. 2014, pp. 289–92. Pubmed, doi:10.1038/leu.2013.176.
Othus M, Kantarjian H, Petersdorf S, Ravandi F, Godwin J, Cortes J, Pierce S, Erba H, Faderl S, Appelbaum FR, Estey E. Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: a report from SWOG and MD Anderson. Leukemia. 2014 Feb;28(2):289–292.

Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

February 2014

Volume

28

Issue

2

Start / End Page

289 / 292

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Retrospective Studies
  • Middle Aged
  • Leukemia, Myeloid, Acute
  • Induction Chemotherapy
  • Immunology
  • Humans
  • Antineoplastic Combined Chemotherapy Protocols
  • Aged, 80 and over