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A randomized study of decitabine versus conventional care for maintenance therapy in patients with acute myeloid leukemia in complete remission

Leukemia volume 26, pages 2428–2431 (2012)Cite this article

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The majority of patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction therapy. Despite intensive consolidation regimens, less than one-third of adult patients with AML are cured, mainly because of a high incidence of relapse.1 In a recently published randomized trial, treatment with azacitidine increased the overall survival (OS) relative to supportive care in patients with myelodysplastic syndrome (MDS).2 Therapy with decitabine (DAC) also improves the outcomes in MDS, including time to AML transformation or death.3 DAC is also active in AML and produces CRs in a number of patients.4

We and others have reported that DNA methylation increases at relapse in patients with AML and may predict the occurrence of relapse, suggesting its involvement in disease progression and providing a rationale for the use of epigenetic agents in maintenance.5, 6 In this study, we compared DAC with conventional care (CC), including low-dose subcutaneous cytarabine, prolonged intensive chemotherapy (IC) or observation, in patients with AML in their first or subsequent CR.

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Acknowledgements

This work was supported in part by the Leukemia SPORE, CA100632 and by a grant from Eisai Pharmaceuticals.

Author Contributions

FR designed the research; RC performed the experiments and JJ performed flow cytometry; and YB, HK, JJ, JA, SF, GGM, GB, EJ, ZE, JC, JPI and FR performed the research, analyzed the data and wrote the manuscript.

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Authors and Affiliations

  1. Division of Cancer Medicine, Hematology/Oncology Fellowship Program, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Y Boumber

  2. Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    H Kantarjian, S Faderl, R Castoro, J Autry, G Garcia-Manero, G Borthakur, E Jabbour, Z Estrov, J Cortes, J-P Issa & F Ravandi

  3. Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    J Jorgensen

  4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    S Wen

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  1. Y Boumber
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Corresponding author

Correspondence to F Ravandi.

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Competing interests

Consultant or advisory role: Jean-Pierre Issa, GSK, Syndax; Farhad Ravandi, Eisai and Johnson and Johnson; honoraria: Jean-Pierre Issa, Celgene, Novartis, Johnson and Johnson; Farhad Ravandi, Eisai and Johnson and Johsnon; research funding: Jean-Pierre Issa, MERC, Eisai, Celgene; Stephan Faderl, Eisai; Gautam Borthakur, Eisai; Jorge Cortes, Eisai; Hagop Kantarjian, Celgene; Farhad Ravandi, Eisai and Johnson and Johsnon.

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Boumber, Y., Kantarjian, H., Jorgensen, J. et al. A randomized study of decitabine versus conventional care for maintenance therapy in patients with acute myeloid leukemia in complete remission. Leukemia 26, 2428–2431 (2012). https://doi.org/10.1038/leu.2012.153

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