Low-Dose Cytarabine versus BestSupportive Care for Patients with AcuteMyeloid Leukaemia Unfit for the Standardof Care: Egyptian Centre Experience

Background: acute myeloid leukaemia (aml) in the elderly is not strong enoughto tolerate aggressive chemotherapy. we conducted the present study to compare theefficacy and safety of low-dose cytarabine (ldac) with best supportive care (bsc)in egyptian patients.method: a prospective randomized study included 60 eligible patients aged over60 years with newly diagnosed aml. they were randomized to receive ldac orbsc. the overall survival (os) was the primary endpoint, while the secondaryendpoint was to compare the quality of life in the form of a length of hospital stays(lohs), mode and frequency of admission in the two studied groups.results: herein, 30 patients received ldac and 30 patients received bsc. themean survival time was 7.5 months in the bsc group compared with 10.2 months inthe ldac group. even though the median os was 8.4 months in the bsc group, itdid not reach in the ldac group; hr= 2.047, ci 95% (0.541-7.743) (p=0.2).there was a statistically significant association with ldac and the frequency ofhospital admission through the emergency department (ed) due to neutropenic feverand prolonged lohs (p<0.001, p<0.002, and p<0.001, respectively).meanwhile, the admission through the outpatient clinic (opc) and for transfusionsupport were statistically insignificant in the two groups (p< 0.12 and p< 0.6,respectively).conclusion: despite, there were no os statistically significant benefits of the useof ldac over bsc in our patients, poor quality of life in the form of frequentadmission through the ed, more incidence of neutropenic fever, and prolonged lohswere reported more to patients received ldac.