Prognostic Index for Adult Patients With Acute Myeloid Leukemia in First Relapse

Breems, Dimitri; Putten, Wim L.J. van; Huijgens, Peter C.; Ossenkoppele, Gert J.; Verhoef, Gregor; Verdonck, Leo F.; Vellenga, Edo; Greef, Georgine E. de; Jacky, E; Lelie, J. Van Der; Boogaerts, Marc; Löwenberg, Bob

doi:10.1200/jco.2005.06.027

Cited by 464 publications

(405 citation statements)

References 23 publications

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“…A successful outcome after salvage therapy depends on duration of first CR, cytogenetics at diagnosis and previous history of ASCT [8][9][25][26][27]. Although the difference was not statistically significant, likely due to the small sample size, we observed that patients younger than 60 years and those with CR1 duration ≥12 months had a higher response rate.…”

Section: Bleedingcontrasting

confidence: 46%

Fludarabine, Cytarabine and Gentuzumab Ozogamicin (FLA-GO) as Salvage Therapy and Bridge to Transplant in Adult Relapsed Acute Myeloid Leukemia (AML) Patients

Principe¹

2017

Ann Hematol Oncol

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Section: Bleedingcontrasting

confidence: 46%

Fludarabine, Cytarabine and Gentuzumab Ozogamicin (FLA-GO) as Salvage Therapy and Bridge to Transplant in Adult Relapsed Acute Myeloid Leukemia (AML) Patients

Principe¹

2017

Ann Hematol Oncol

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“…Outcome of allografts beyond first remission, however, is inferior to that in first-remission patients, owing to an increase in both treatmentrelated mortality (25%-35%) and relapse (40%-45%). Breems et al reported a prognostic index for adult patients with relapsed AML based on a cohort of 667 AML patients in first relapse (115). Four relevant parameters significantly predicted for outcome, including length of relapse free interval, age at relapse, cytogenetics at diagnosis, and whether or not patients had received a previous transplantation.…”

Section: Transplantation In Second Remissionmentioning

confidence: 99%

The European LeukemiaNet AML Working Party consensus statement on allogeneic HSCT for patients with AML in remission: an integrated-risk adapted approach

et al. 2012

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Allogeneic hematopoietic stem cell transplantation (alloHSCT) is frequently applied as part of treatment in acute myeloid leukemia (AML) in first or subsequent remission. It reduces relapse, but non-relapse mortality (NRM) and morbidity may counterbalance that beneficial effect. Here we review recent studies reporting new disease specific prognostic markers as well as alloHSCT related risk factors to be identified at specific time points during treatment. We propose risk assessment as a dynamic process during treatment, incorporating both disease and transplant related factors for the decision to proceed either to alloHSCT or with a non transplant strategy, whereby alloHSCT may be favored if projected disease free survival can be expected to be improved by at least 10%, based on individual risk assessment. Pivotal for such an approach are initial disease risk assessment, search for a sibling or unrelated donor early after diagnosis, and the incorporation of time dependent risk factors, all within the context of an integrated therapeutic management approach.4

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“…Older individuals with myeloid diseases also have high risk cytogenetic phenotypes and increased multidrug resistance gene expression [1][2][3]; hence they are less likely cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation (HSCT) is potentially curative with a reported disease-free survival (DFS) of 30-50% [4][5][6][7][8][9]. In MDS, HSCT is the only therapy known to improve survival [10].…”

Section: Introductionmentioning

confidence: 99%

Reduced intensity compared with high dose conditioning for allotransplantation in acute myeloid leukemia and myelodysplastic syndrome: A comparative clinical analysis

et al. 2007

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We evaluated the efficacy of hematopoietic stem cell transplantation (HSCT) using reduced intensity (RI) vs. myeloablative (MA) conditioning for patients with acute myeloid leukemia (AML) and myelodysplastic syndrome. Thirty two patients (median age 54) who underwent a RI HSCT (2000HSCT ( -2003 were compared with 187 patients (median age 39) who received a MA transplant (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003). Neutrophil engraftment was more rapid in the RI group (median 11.5 vs. 21 days). Platelet recovery was similar and graft failure was infrequent. The incidence of graft-versus-host disease (GVHD) and treatment-related mortality was similar though relapse was more frequent after RI conditioning (RR 2.2 [95% CI 5 1.1-4.6] P 5 0.03). At 2 years, disease-free survival (DFS) (31% vs. 30%, P > 0.1) and overall survival (33% vs. 35%, P > 0.1) were comparable between RI and MA groups, respectively. We suggest that RI allografts can yield satisfactory DFS both for older as well as younger patients with pre-existing comorbidities, who are ineligible for MA allografts. Advances in GVHD management and new approaches for relapsed or refractory disease are necessary to improve these outcomes. Am. J. Hematol. 82:867-872, 2007. V

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Prognostic Index for Adult Patients With Acute Myeloid Leukemia in First Relapse

Abstract: The prognostic index estimates the outcome of AML patients in first relapse using four commonly applied clinical parameters and might identify patients who are candidates for salvage and investigational therapy.

Cited by 464 publications

References 23 publications

Fludarabine, Cytarabine and Gentuzumab Ozogamicin (FLA-GO) as Salvage Therapy and Bridge to Transplant in Adult Relapsed Acute Myeloid Leukemia (AML) Patients

Fludarabine, Cytarabine and Gentuzumab Ozogamicin (FLA-GO) as Salvage Therapy and Bridge to Transplant in Adult Relapsed Acute Myeloid Leukemia (AML) Patients

The European LeukemiaNet AML Working Party consensus statement on allogeneic HSCT for patients with AML in remission: an integrated-risk adapted approach

Reduced intensity compared with high dose conditioning for allotransplantation in acute myeloid leukemia and myelodysplastic syndrome: A comparative clinical analysis

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