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BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies
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 ≥6...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585096/ https://www.ncbi.nlm.nih.gov/pubmed/34768616 http://dx.doi.org/10.3390/jcm10215096 |
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author | Tiribelli, Mario Michelutti, Angela Cavallin, Margherita Di Giusto, Sara Simeone, Erica Fanin, Renato Damiani, Daniela |
author_facet | Tiribelli, Mario Michelutti, Angela Cavallin, Margherita Di Giusto, Sara Simeone, Erica Fanin, Renato Damiani, Daniela |
author_sort | Tiribelli, Mario |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8585096 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-85850962021-11-12 BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies Tiribelli, Mario Michelutti, Angela Cavallin, Margherita Di Giusto, Sara Simeone, Erica Fanin, Renato Damiani, Daniela J Clin Med Article 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. MDPI 2021-10-30 /pmc/articles/PMC8585096/ /pubmed/34768616 http://dx.doi.org/10.3390/jcm10215096 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Tiribelli, Mario Michelutti, Angela Cavallin, Margherita Di Giusto, Sara Simeone, Erica Fanin, Renato Damiani, Daniela BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title | BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title_full | BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title_fullStr | BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title_full_unstemmed | BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title_short | BCL-2 Expression in AML Patients over 65 Years: Impact on Outcomes across Different Therapeutic Strategies |
title_sort | bcl-2 expression in aml patients over 65 years: impact on outcomes across different therapeutic strategies |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8585096/ https://www.ncbi.nlm.nih.gov/pubmed/34768616 http://dx.doi.org/10.3390/jcm10215096 |
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