Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype
| Autor: | Marian Stevens-Kroef, Giovanna Meloni, Simona Sica, Xavier Thomas, Jean-Pierre Marie, Anne Hagemeijer, Constantijn J.M. Halkes, Adriano Venditti, Francesco Albano, Marco Mancini, Joop H. Jansen, Roelof Willemze, Radovan Vrhovac, Stefan Suciu, François Lefrère, Theo de Witte, Michal Kicinski, Petra Muus, Frédéric Baron, Sergio Amadori |
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| Rok vydání: | 2019 |
| Předmět: |
Oncology
Male BLOOD medicine.medical_treatment Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Abnormal Karyotype Hematopoietic stem cell transplantation Monosomy Antineoplastic Combined Chemotherapy Protocols Odds Ratio IMPROVES Medicine induction regimen allogeneic hematopoietic cell transplantation acute myeloid leukemia monosomal karyotype Etoposide Cytogenetics and Molecular Genetics Age Factors Hematopoietic Stem Cell Transplantation Myeloid leukemia Induction Chemotherapy Hematology Middle Aged Prognosis Combined Modality Therapy HIGH-DOSE CYTARABINE Leukemia Myeloid Acute Treatment Outcome WORKING PARTY Female Life Sciences & Biomedicine medicine.drug Adult Acute Myeloid Leukemia medicine.medical_specialty Monosomal karyotype Transplantation Adolescent PROGNOSTIC IMPACT Article Young Adult All institutes and research themes of the Radboud University Medical Center Internal medicine Autologous transplantation Idarubicin Humans Transplantation Homologous EUROPEAN GROUP Science & Technology business.industry INTENSITY Induction chemotherapy Survival Analysis Cytarabine business Settore MED/15 - Malattie del Sangue |
| Zdroj: | Haematologica, 104, 1168-1175 Haematologica, 104(6), 1168-1175. FERRATA STORTI FOUNDATION Haematologica Haematologica, 104, 6, pp. 1168-1175 |
| ISSN: | 0390-6078 |
| Popis: | Monosomal karyotype confers a poor prognosis in patients with acute myeloid leukemia. Here, we determined the impact of the type of remission-induction chemotherapy and the impact of having a donor in younger acute myeloid leukemia patients with a monosomal karyotype included in two phase III trials. In the first trial patients were randomized to receive either daunorubicin, mitoxantrone, or idarubicin in addition to standard-dose cytarabine and etoposide for induction chemotherapy. In the second trial patients were randomized to standard-dose cytarabine or high-dose cytarabine induction, both with daunorubicin and etoposide. In both trials, patients who achieved a complete remission with or without complete hematologic recovery underwent allogeneic hematopoietic stem cell transplantation if they had a donor; otherwise, they underwent autologous transplantation. In comparison to patients with intermediate-risk cytogenetics without a monosomal karyotype (n=1,584) and with adverse cytogenetics without a monosomal karyotype (n=218), patients with a monosomal karyotype (n=188) were more likely not to achieve a complete remission with or without count recovery [odds ratio=2.85, 95% confidence interval (95%, CI): 2.10-3.88] and had shorter overall survival [hazard ratio, (HR)=2.44, 95% CI: 2.08-2.88]. There was no impact of the type of anthracycline or of the dose of cytarabine on outcomes in patients with a monosomal karyotype. Among monosomal karyo type patients who achieved a complete remission with or without count recovery, HLA-identical related donor availability was associated with longer survival from complete remission with or without count recovery (HR=0.59, 95% CI: 0.37-0.95). ClinicalTrials.gov identifiers: AML-10: NCT00002549; AML-12: NCT00004128. ispartof: HAEMATOLOGICA vol:104 issue:6 pages:1168-1175 ispartof: location:Italy status: published |
| Databáze: | OpenAIRE |
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