Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Peter W. Marks

Second Advisor

Nikolai A. Podoltsev

Subject Area(s)

Oncology

Abstract

Specific aims: This single-center, retrospective study compared overall survival and hospitalization in older patients with acute myeloid leukemia (AML) receiving first-line treatment with standard induction chemotherapy and decitabine therapy.

Methods: Between January 2000 and December 2009, 36 patients at Yale-New Haven Hospital age 65 years and older with newly diagnosed AML received standard induction chemotherapy (n=11), decitabine therapy (n=11), or supportive care only (n=14). Data obtained included baseline characteristics, achievement of remission, overall survival, inpatient and outpatient visits, and early death.

Results: When compared to standard induction chemotherapy, decitabine patients were significantly older (77 vs 69 years, P = .020) yet had a favorable but nonsignificant trend for increased overall survival (9 vs 7 months, P = .192) and spent significantly fewer days in the hospital (30 vs 41 days, P = .047). Supportive care patients were older (84.5 years) and had a median survival of only 0.6 months.

Conclusions: Compared to standard induction chemotherapy, decitabine as first-line therapy for AML in older patients reduced hospitalization and had a similar overall survival.

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