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去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析
OBJECTIVE: To explore outcomes in adult with de novo acute myeloid leukemia (AML) received IA10 (10 mg/m(2) d1–3 idarubicin plus cytarabine 100 mg/m(2) d1–7) regimen as induction chemotherapy. METHODS: From January 2008 to February 2016, data of consecutive newly-diagnosed AML (non-M(3)) adults trea...
Formato: | Online Artículo Texto |
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Lenguaje: | English |
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Editorial office of Chinese Journal of Hematology
2018
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343116/ https://www.ncbi.nlm.nih.gov/pubmed/29551027 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.01.004 |
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collection | PubMed |
description | OBJECTIVE: To explore outcomes in adult with de novo acute myeloid leukemia (AML) received IA10 (10 mg/m(2) d1–3 idarubicin plus cytarabine 100 mg/m(2) d1–7) regimen as induction chemotherapy. METHODS: From January 2008 to February 2016, data of consecutive newly-diagnosed AML (non-M(3)) adults treated with IA10 who achieved morphologic leukemia-free state (MLFS) but not accepted allogeneic hematopoietic stem cell transplantation (allo-HSCT) were assessed retrospectively. RESULTS: A total of 198 patients were included in this study with 96 (48.5%) male and a median age of 42 years old (range, 18–62 years old). Using the SWOG cytogenetic classification, 45 (22.7%), 104 (52.5%), 24 (12.1%) and 25 (12.6%) patients belonged to favorable, intermediate, unfavorable and unknown categories, respectively. 6 (3.0%) patients had monosomal karyotype, and 28 (14.1%) positive FLT3-ITD mutation. A complete remission (CR, defined as MLFS with ANC≥1×10(9)/L and PLT≥100×10(9)/L) achieved in 168 (84.8%) patients, a CRp (defined as MLFS with incomplete PLT recovery) in 16 (8.1%) and a CRi (defined as MLFS with incomplete ANC and PLT recovery) in 14 (7.1%). With a median follow-up period of 15 months (range, 1 to 70 months) in survivors, the probabilities of cumulative incident of relapse (CIR), disease free survival (DFS) and overall survival (OS) rates at 2-year were 45.2%, 46.9% and 62.9%, respectively; the median durations of relapse, DFS and OS were 34, 20 and 37 months respectively. At the time of achieving first MLFS, multivariate analyses showed that positive FLT3-ITD mutation and CRi were common adverse factors affecting CIR, DFS and OS; unfavorable-risk of SWOG criteria was an adverse factor affecting CIR and DFS; monosomal karyotype was associated with shorter OS. After first consolidation therapy, FLT3-ITD mutation positive and unfavorable-risk of SWOG criteria had negatively impact on CIR, DFS and OS; peripheral blasts ≥0.50 and positive MRD (defined as RQ-PCR WT1 mRNA ≥0.6% or any level of abnormal blast population detected by flow cytometry) after first consolidation therapy were common adverse factors affecting CIR and DFS; CRi was an adverse factor affecting DFS and OS. CONCLUSION: In adult with de novo AML received IA10 regimen as induction regimen, unfavorable molecular markers or cytogenetics at diagnosis and CRi independently predicted poor outcome. In addition, a higher percentage of peripheral blasts, monosomal karyotype and positive MRD after first consolidation therapy had negatively impact on outcomes. |
format | Online Article Text |
id | pubmed-7343116 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Editorial office of Chinese Journal of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-73431162020-07-16 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: To explore outcomes in adult with de novo acute myeloid leukemia (AML) received IA10 (10 mg/m(2) d1–3 idarubicin plus cytarabine 100 mg/m(2) d1–7) regimen as induction chemotherapy. METHODS: From January 2008 to February 2016, data of consecutive newly-diagnosed AML (non-M(3)) adults treated with IA10 who achieved morphologic leukemia-free state (MLFS) but not accepted allogeneic hematopoietic stem cell transplantation (allo-HSCT) were assessed retrospectively. RESULTS: A total of 198 patients were included in this study with 96 (48.5%) male and a median age of 42 years old (range, 18–62 years old). Using the SWOG cytogenetic classification, 45 (22.7%), 104 (52.5%), 24 (12.1%) and 25 (12.6%) patients belonged to favorable, intermediate, unfavorable and unknown categories, respectively. 6 (3.0%) patients had monosomal karyotype, and 28 (14.1%) positive FLT3-ITD mutation. A complete remission (CR, defined as MLFS with ANC≥1×10(9)/L and PLT≥100×10(9)/L) achieved in 168 (84.8%) patients, a CRp (defined as MLFS with incomplete PLT recovery) in 16 (8.1%) and a CRi (defined as MLFS with incomplete ANC and PLT recovery) in 14 (7.1%). With a median follow-up period of 15 months (range, 1 to 70 months) in survivors, the probabilities of cumulative incident of relapse (CIR), disease free survival (DFS) and overall survival (OS) rates at 2-year were 45.2%, 46.9% and 62.9%, respectively; the median durations of relapse, DFS and OS were 34, 20 and 37 months respectively. At the time of achieving first MLFS, multivariate analyses showed that positive FLT3-ITD mutation and CRi were common adverse factors affecting CIR, DFS and OS; unfavorable-risk of SWOG criteria was an adverse factor affecting CIR and DFS; monosomal karyotype was associated with shorter OS. After first consolidation therapy, FLT3-ITD mutation positive and unfavorable-risk of SWOG criteria had negatively impact on CIR, DFS and OS; peripheral blasts ≥0.50 and positive MRD (defined as RQ-PCR WT1 mRNA ≥0.6% or any level of abnormal blast population detected by flow cytometry) after first consolidation therapy were common adverse factors affecting CIR and DFS; CRi was an adverse factor affecting DFS and OS. CONCLUSION: In adult with de novo AML received IA10 regimen as induction regimen, unfavorable molecular markers or cytogenetics at diagnosis and CRi independently predicted poor outcome. In addition, a higher percentage of peripheral blasts, monosomal karyotype and positive MRD after first consolidation therapy had negatively impact on outcomes. Editorial office of Chinese Journal of Hematology 2018-01 /pmc/articles/PMC7343116/ /pubmed/29551027 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.01.004 Text en 2018年版权归中华医学会所有 http://creativecommons.org/licenses/by-nc-sa/3.0/ This work is licensed under a Creative Commons Attribution 3.0 License (CC-BY-NC). The Copyright own by Publisher. Without authorization, shall not reprint, except this publication article, shall not use this publication format design. Unless otherwise stated, all articles published in this journal do not represent the views of the Chinese Medical Association or the editorial board of this journal. |
spellingShingle | 论著 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title_full | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title_fullStr | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title_full_unstemmed | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title_short | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
title_sort | 去甲氧柔红霉素联合阿糖胞苷治疗初发急性髓系白血病的预后分析 |
topic | 论著 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7343116/ https://www.ncbi.nlm.nih.gov/pubmed/29551027 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2018.01.004 |
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