Maintenance therapy with a combination of azacitidine, danazol, and thalidomide after intensive chemotherapy in patients with acute myeloid leukemia

Hematology. 2023 Dec;28(1):2276550. doi: 10.1080/16078454.2023.2276550. Epub 2023 Nov 2.

Abstract

Objective: This study aimed to evaluate the efficacy of azacitidine (AZA) combined with danazol (DNZ) and thalidomide (THD) maintenance therapy after intensive chemotherapy (IC) in patients with acute myeloid leukemia (AML).

Methods: we retrospectively analyzed the clinical data of 11 patients treated with AZA combined with DNZ and THD as maintenance therapy after IC at the Baiyun Hospital were between February 2017 and March 2021. The patients' clinical features, relapse-free survival (RFS), and overall survival (OS) were analyzed.

Results: Eleven cases fulfilled the AML criteria per the 2016 World Health Organization classification. Of the 11 patients, five were females, and six were males, with a median age of 45 years (range, 23-65 years). Ten patients were in the first complete remission (CR1), and one patient was in the second complete remission (CR2). All patients received AZA combined with DNZ and THD maintenance therapy after IC. The median number of AZA cycles received was 7 (6-12). Until June 2022, the median follow-up period was 37 (14-63) months; one patient had a relapse, and three died. RFS at 1 year and 3 years was 100% and 71.1%, respectively, and OS at 3 years was 100%.

Conclusion: AZA combined with DNZ and THD maintenance therapy is effective for patients with AML who are ineligible for allogeneic hematopoietic stem cell transplantation. Further studies with large sample sizes and randomized are needed to verify these findings.

Keywords: Azacitidine; acute myeloid leukemia; danazol; maintenance therapy; thalidomide.

MeSH terms

  • Adult
  • Aged
  • Antimetabolites, Antineoplastic / therapeutic use
  • Azacitidine / therapeutic use
  • Danazol / therapeutic use
  • Female
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Leukemia, Myeloid, Acute*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Thalidomide / therapeutic use
  • Young Adult

Substances

  • Azacitidine
  • Thalidomide
  • Danazol
  • Antimetabolites, Antineoplastic