Naslov
Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype

Autori
Baron, Frédéric ; Stevens-Kroef, Marian ; Kicinski, Michal ; Meloni, Giovanna ; Muus, Petra ; Marie, Jean- Pierre ; Halkes, Constantijn J.M. ; Thomas, Xavier ; Vrhovac, Radovan ; Albano, Francesco ; Lefrère, François ; Sica, Simona ; Mancini, Marco ; Venditti, Adriano ; Hagemeijer, Anne ; Jansen, Joop H. ; Amadori, Sergio ; de Witte, Theo ; Willemze, Roelof ; Suciu, Stefan

Izvornik
Haematologica (0390-6078) 104 (2018), 19; 1168-1175

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
induction regimen ; allogeneic hematopoietic cell transplantation ; acute myeloid leukemia ; monosomal karyotype

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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