Impact of induction regimen and allogeneic hematopoietic cell transplantation on outcome in younger adults with acute myeloid leukemia with a monosomal karyotype.
Haematologica
; 104(6): 1168-1175, 2019 06.
Article
de En
| MEDLINE
| ID: mdl-30523055
ABSTRACT
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.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Leucémie aigüe myéloïde
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Transplantation de cellules souches hématopoïétiques
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Caryotype anormal
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Monosomie
Type d'étude:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
/
Prognostic_studies
Limites:
Adolescent
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Adult
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Female
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Humans
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Male
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Middle aged
Langue:
En
Journal:
Haematologica
Année:
2019
Type de document:
Article
Pays d'affiliation:
Belgique