Day 14 Bone Marrow Evaluation During Acute Myeloid Leukemia Induction in a Real-world Canadian Cohort
| Autor: | Donna L. Forrest, Thomas J. Nevill, Maryse M. Power, James T. England, Florian Kuchenbauer, David Sanford, Donna E. Hogge, Joseph Brandwein, Lalit Saini, Monika Hudoba, Sujaatha Narayanan, Artur J. Szkotak |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Canada Multivariate analysis Time Factors Adolescent Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Trephine biopsy Bone Marrow Internal medicine Induction therapy Medicine Humans Aged business.industry Complete remission Myeloid leukemia Cancer Hematology Middle Aged medicine.disease Leukemia Myeloid Acute medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort Female Bone marrow business 030215 immunology |
| Zdroj: | Clinical lymphoma, myelomaleukemia. 20(7) |
| ISSN: | 2152-2669 |
| Popis: | The 2017 National Comprehensive Cancer Network guidelines for acute myeloid leukemia have recommended performing bone marrow (BM) aspiration and BM trephine biopsy (BMTB) 14 to 21 days after starting induction therapy (commonly referred to as "day 14 [D14] marrow"). Those who do not achieve a hypoplastic marrow, with cellularity 20% and blasts 5%, are recommended to undergo 2-cycle induction (2CI). We performed a retrospective analysis to determine the impact of D14 BM characteristics in predicting for remission, association with overall survival (OS), and the effect of 2CI according to the D14 BM results.Patients aged 18 to 70 years undergoing induction therapy with standard "7 + 3" regimens were included. D14 cellularity was determined from BMTB samples and the blast percentage was assessed by morphology on BM aspiration and BMTB samples. The outcomes evaluated included the rates of complete remission (CR) and OS.A total of 486 patients with results from D14 BM evaluation were included in the present study. On multivariate analysis, cytogenetic risk and D14 blasts 5% were predictive of CR/CR with incomplete count recovery (P .001). Cytogenetic risk (P .001), age 60 years (P = .001), and D14 blasts 5% (P = .045) predicted for OS. 2CI was performed in 131 patients (27%). Patients with hypocellular D14 BM but residual blasts (n = 106) underwent 2CI in 46% of cases, with improved remission rates (43.9% vs. 72.0%; P = .004) but no difference in OS.The results from D14 BM evaluations are predictive of subsequent remission and OS. Our findings did not show a survival benefit with D14 BM-driven 2CI. |
| Databáze: | OpenAIRE |
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