Azacitidine alone offered better 1-year survival than continuous high-dose lenalidomide or sequential lenalidomide and azacytidine in patients with acute myeloid leukemia (AML), according to a multi-center, randomized, open-label, phase-2 trial involving 87 individuals. Participants were ≥65 years of age and had newly-diagnosed AML. 15% had prior myelodysplastic syndrome and 47% had adverse cytogenetics. They were given 1 of the following regimens: 1) continuous high-dose lenalidomide (n=15); 2) sequential azacitidine and lenalidomide (n=39); or 3) azacytidine only (n=34). Investigators looked at 1-year survival rates, which were:
- 21% with high-dose lenalidomide.
- 44% with sequential azacitidine and lenalidomide.
- 52% with azacitidine only.
Continuous high-dose lenalidomide resulted in a high rate of early discontinuations. Death risk in the first 4 months was highest in this group.
Medeiros B, McCaul K, Kambhampati S, et al. Randomized study of continuous high-dose lenalidomide, sequential azacitidine and lenalidomide or azacitidine in persons ≥65 years with newly-diagnosed acute myeloid leukemia. [Published online ahead of print October 26, 2017]. Haematologica. doi:10.3324/haematol.2017.172353.
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