Article (Scientific journals)
Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype
BARON, Frédéric; Stevens-Kroef, Marian; Kicinski, Michal et al.
2019In Haematologica, 104, p. 1168-1175
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Keywords :
Acute Myeloid Leukemia; Cytogenetics and Molecular Genetics; Monosomal karyotype; Transplantation
Abstract :
[en] 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.
Disciplines :
Hematology
Author, co-author :
BARON, Frédéric  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service d'hématologie clinique
Stevens-Kroef, Marian
Kicinski, Michal
Meloni, Giovanna
Muus, Petra
Marie, Jean-Pierre
Halkes, Constantijn J. M.
Thomas, Xavier
Vrhovac, Radovan
Albano, Francesco
Lefrere, Francois
Sica, Simona
Mancini, Marco
Venditti, Adriano
Hagemeijer, Anne
Jansen, Joop H.
Amadori, Sergio
de Witte, Theo
Willemze, Reol
Suciu, Stefan
More authors (10 more) Less
Language :
English
Title :
Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype
Publication date :
2019
Journal title :
Haematologica
ISSN :
0390-6078
eISSN :
1592-8721
Publisher :
Ferrata Storti Foundation, Italy
Volume :
104
Pages :
1168-1175
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 08 January 2019

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