Dexamethasone in hyperleukocytic acute myeloid leukemia
| Autor: | Sarah Bertoli, Muriel Picard, Emilie Bérard, Emmanuel Griessinger, Clément Larrue, Pierre Luc Mouchel, François Vergez, Suzanne Tavitian, Edwige Yon, Jean Ruiz, Eric Delabesse, Isabelle Luquet, Laetitia Karine Linares, Estelle Saland, Martin Carroll, Gwenn Danet-Desnoyers, Audrey Sarry, Françoise Huguet, Jean Emmanuel Sarry, Christian Récher |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Haematologica, Vol 103, Iss 6 (2018) |
| Druh dokumentu: | article |
| ISSN: | 0390-6078 1592-8721 |
| DOI: | 10.3324/haematol.2017.184267 |
| Popis: | Patients with acute myeloid leukemia and a high white blood cell count are at increased risk of early death and relapse. Because mediators of inflammation contribute to leukostasis and chemoresistance, dexamethasone added to chemotherapy could improve outcomes. This retrospective study evaluated the impact of adding or not adding dexamethasone to chemotherapy in a cohort of 160 patients with at least 50×109 white blood cells. In silico studies, primary samples, leukemic cell lines, and xenograft mouse models were used to explore the antileukemic activity of dexamethasone. There was no difference with respect to induction death rate, response, and infections between the 60 patients in the dexamethasone group and the 100 patients in the no dexamethasone group. Multivariate analysis showed that dexamethasone was significantly associated with improved relapse incidence (adjusted sub-HR: 0.30; 95% CI: 0.14–0.62; P=0.001), disease-free survival (adjusted HR: 0.50; 95% CI: 0.29–0.84; P=0.010), event-free survival (adjusted HR: 0.35; 95% CI: 0.21–0.58; P |
| Databáze: | Directory of Open Access Journals |
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