BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies
| Autor: | Mario Tiribelli, Renato Fanin, Daniela Damiani, Sara Di Giusto, Margherita Cavallin, Angela Michelutti, Erica Simeone |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty education.field_of_study Chemotherapy Acute myeloid leukemia Survival business.industry medicine.medical_treatment Population Complete remission Myeloid leukemia BCL-2 General Medicine Prognosis Article Elderly Internal medicine Induction therapy medicine Overall survival Medicine education business |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 5096, p 5096 (2021) Journal of Clinical Medicine Volume 10 Issue 21 |
| ISSN: | 2077-0383 |
| Popis: | BCL-2 overexpression has been associated with resistance to chemotherapy and reduced survival in acute myeloid leukemia (AML), but few data are available in elderly patients, a subset accounting for majority of AML cases and with dismal prognosis. We retrospectively analyzed 113 AML patients aged ≥65 years treated with 3 + 7 chemotherapy (n = 51) or hypomethylating agents (HMAs) (n = 62), evaluating the role of BCL-2 expression on complete remission (CR) and overall survival (OS). BCL-2 was expressed in 81 patients (72%), more frequently in those with unfavorable cytogenetic-molecular risk. CR was achieved in 34.5% cases, without differences according to BCL-2 expression or induction therapy. In the whole population 1-year OS was 39%, similar in BCL-2+ and BCL-2- cases. In BCL-2 positive patients OS was superior with HMAs (56% vs. 25% with 3 + 7 p = 0.02), while no advantage for HMA was found in BCL-2 negative cases (36% vs. 27% for 3 + 7). Therapy with HMAs was the only factor associated with longer OS in BCL-2+ AML by multivariable analysis. Use of HMAs, possibly in combination with BCL-2 inhibitors, appears to be particularly appealing in BCL2+ AML, where it is associated with superior survival. |
| Databáze: | OpenAIRE |
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