Abstract |
The histone deacetylase inhibitor (HDACi) valproic acid (VPA) has been shown to be active on acute myeloid leukemia (AML) and refractory anemia with excess of blasts ( RAEB). Thirty-one elderly AML/ RAEB patients (AML n=25; RAEB n=6) with a high rate of comorbidity were entered in a phase II study with low-dose cytarabine ( Ara-C) and VPA. Fitness was evaluated by means of the Comprehensive Geriatric Assessment (CGA), including the Cumulative Illness Rating Scale (CIRS) score, the self-sufficiency scores of Activity of Daily Living ( ADL) and Instrumental Activity of Daily Living (IADL). Eight patients obtained a lasting complete remission and 3 other patients obtained hematologic improvement for a total response rate of 35%. Five of 11 responding patients were relapsed or resistant after a previous treatment with Ara-C. Seven of 11 responding patients were assessed as frail at enrollment and/or had IADL impairment. Grades 3 and 4 toxicities were mainly hematological. Low-dose Ara-C and VPA is a relatively non-toxic combination with good therapeutic activity in elderly patients with AML/ RAEB. This therapeutic approach represents an alternative treatment for patients who cannot undergo standard induction therapy.
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Authors | M T Corsetti, F Salvi, S Perticone, A Baraldi, L De Paoli, S Gatto, D Pietrasanta, M Pini, V Primon, F Zallio, A Tonso, M G Alvaro, G Ciravegna, A Levis |
Journal | Leukemia research
(Leuk Res)
Vol. 35
Issue 8
Pg. 991-7
(Aug 2011)
ISSN: 1873-5835 [Electronic] England |
PMID | 21474179
(Publication Type: Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011. Published by Elsevier Ltd. |
Chemical References |
- Anticonvulsants
- Antimetabolites, Antineoplastic
- Cytarabine
- Valproic Acid
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Topics |
- Aged
- Aged, 80 and over
- Anemia, Refractory, with Excess of Blasts
(drug therapy, genetics, pathology)
- Anticonvulsants
(therapeutic use)
- Antimetabolites, Antineoplastic
(therapeutic use)
- Cytarabine
(therapeutic use)
- Drug Therapy, Combination
- Feasibility Studies
- Female
- Follow-Up Studies
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute
(drug therapy, genetics, pathology)
- Male
- Middle Aged
- Neoplasm Recurrence, Local
(drug therapy, genetics, pathology)
- Remission Induction
- Survival Rate
- Treatment Outcome
- Valproic Acid
(therapeutic use)
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