Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience
Clinics
; Clinics;75: e1566, 2020. tab, graf
Article
在 En
| LILACS
| ID: biblio-1101081
Responsible library:
BR1.1
ABSTRACT
OBJECTIVES:
The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used.METHODS:
We conducted a retrospective comparison of "MEC" (mitoxantrone, etoposide, and cytarabine) and "FLAG-IDA" (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML.RESULTS:
In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant FLT3-ITD mutation (hazard ratio [HR]=4.6, p<0.001) and SCT (HR=0.43, p=0.01).CONCLUSION:
In our analysis, there were no significant differences between the chosen regimens. High rates of early toxicity were found, emphasizing the role of supportive care and judicious selection of patients who are eligible for intensive salvage therapy in this setting. The FLT3-ITD mutation and SCT remained significant factors for survival in our study, in line with the results of previous studies.Key words
全文:
1
索引:
LILACS
主要主题:
Leukemia, Myeloid, Acute
/
Antineoplastic Combined Chemotherapy Protocols
/
Salvage Therapy
研究类型:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
限制:
Adolescent
/
Adult
/
Female
/
Humans
语言:
En
期刊:
Clinics
期刊主题:
MEDICINA
年:
2020
类型:
Article