Combination treatment of flag with non-pegylated liposomal doxorubicin (myocet™) in elderly patients with acute myeloid leukemia: A single center experience

Lorella Melillo, D. Valente, G. D'Arena, M. Dell'Olio, A. Falcone, M. M. Minervini, M. Nobile, G. Rossi, G. Sanpaolo, P. R. Scalzulli, N. Cascavilla

Research output: Contribution to journalArticle

Abstract

The incidence of acute myeloid leukemia (AML) increases with age, but results of intensive chemotherapy in elderly patients are disappointing. Non-pegylated liposomal formulations of doxorubicin (Myocet™) have been developed with the aim of reducing systemic and cardiac toxicity especially in the elderly. We evaluated the efficacy and toxicity profiles of fludarabine, cytarabine and granulocyte colony-stimulating factor (FLAG) regimen given in association with Myocet™ in 35 patients with AML, median age 69 years (range 61-83 years). Nineteen (54.3%) had newly-diagnosed AML, twelve (34.3%) patients had secondary AML (ten with Myelodisplastic Syndrome, two with Primary Myelofibrosis) and 4 (11.4%) patients had had a late relapse (> 12 months) of AML. Complete remission (CR) and partial remission (PR) were obtained in twenty-two (63%) and 3 (8.5%) patients, respectively. Seven (20%) patients showed a resistant disease. There were 3 early deaths (8.5%). Six patients (17%) experienced severe cardiovascular toxicity. The median overall survival (OS) was 12 months (range 1-52 months) with a median disease-free survival (DFS) of 20 months (range 1-48 months). One-year and two-year DFS were 78.9% and 26.7%, respectively. This study demonstrates that in elderly patients with AML, FLAG-Myocet™ combination shows promising efficacy response with acceptable toxicity, enabling most patients to receive further treatments, including transplantation procedures.

Original languageEnglish
Pages (from-to)703-709
Number of pages7
JournalInternational Journal of Immunopathology and Pharmacology
Volume24
Issue number3
Publication statusPublished - Jul 2011

Keywords

  • Acute myeloid leukemia
  • Elderly FLAG-Myocet™ combination

ASJC Scopus subject areas

  • Pharmacology
  • Immunology
  • Immunology and Allergy

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