Ontology type: schema:ScholarlyArticle Open Access: True
2019-09-25
AUTHORSPierre-Edouard Debureaux, Myriam Labopin, Anne-Claire Mamez, Simona Lapusan, Francoise Isnard, Rosa Adaeva, Agnès Bonnin, Pierre Hirsch, Francois Delhommeau, Giorgia Battipaglia, Remy Duléry, Florent Malard, Anne Vekhoff, Mohamad Mohty, Ollivier Legrand, Eolia Brissot
ABSTRACTOptimization of the salvage regimen is required to improve prognosis in primary refractory or relapsed acute myeloid leukemia (AML). In fit patients, a bridge to allogeneic transplant is the primary purpose of salvage. We tested the combination of fractionated gemtuzumab ozogamicin with cytarabine and mitoxantrone (MYLODAM schema) with primary endpoint of efficacy and safety. We also attempted to define predictive factors for survival and response after salvage. We included 58 patients with a median age at salvage of 56 years. The overall response rate was 67%. Leukemia-free survival (LFS) and overall survival (OS) at 2 years was 36% (95% CI: 23–49) and 54% (95% CI: 39–68), respectively. Treatment-related mortality was 7%. Three veno-occlusive diseases (SOS/VOD) occurred during salvage. In the allogeneic group of 28 patients (48%), LFS and OS at 2 years was 57 % (95% CI: 36.3–77.5) and 69 % (95% CI: 49.3–88.7), respectively. Incidences of nonrelapse mortality, grade II–IV acute graft-versus-host disease (GVHD) and chronic GVHD were 16%, 40%, and 45%, respectively. A GO-based intensive regimen is a viable option for salvage therapy and a feasible schedule as a bridge to allogeneic transplant. More... »
PAGES452-460
http://scigraph.springernature.com/pub.10.1038/s41409-019-0690-2
DOIhttp://dx.doi.org/10.1038/s41409-019-0690-2
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