726 results on '"Myeloid leukaemia"'
Search Results
2. Outcomes of non‐myeloablative allogeneic stem cell transplant in older patients with acute myeloid leukaemia in first remission
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Phillip C. Nguyen, Ing Soo Tiong, Anthony P. Schwarer, David Kliman, Chun Y Fong, Kate Manos, David J. Curtis, and Andrew H. Wei
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Oncology ,medicine.medical_specialty ,Transplantation Conditioning ,medicine.medical_treatment ,Graft vs Host Disease ,Older patients ,Recurrence ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Chemotherapy ,business.industry ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Consolidation Chemotherapy ,Transplantation ,Leukemia, Myeloid, Acute ,Regimen ,Treatment Outcome ,Cohort ,Neoplasm Recurrence, Local ,Stem cell ,Myeloid leukaemia ,business ,Stem Cell Transplantation - Abstract
The benefits of non-myeloablative stem cell transplant in older patients with acute myeloid leukaemia are unclear. We compare the long-term outcomes of this regimen in those aged 55-65 years in first remission with a chemotherapy only cohort that achieved durable morphologic remission. Five-year overall survival was similar (32% vs 33%, P = 0.90), as was relapse-free survival (23% vs 20%, P = 0.37). There was a trend for decreased relapse that was balanced against increased non-relapse mortality with transplantation.
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- 2021
3. Economic impact of genomic diagnostics for intermediate‐risk acute myeloid leukaemia
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Stuart Peacock, Corneliu Bolbocean, Aly Karsan, Dean A. Regier, Donna E. Hogge, Sonya Cressman, and Emily McPherson
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Oncology ,Adult ,medicine.medical_specialty ,Canada ,Cost effectiveness ,medicine.medical_treatment ,Cost-Benefit Analysis ,intermediate‐risk AML ,Gene mutation ,Decision Support Techniques ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Quality of life ,Recurrence ,Risk Factors ,Internal medicine ,Cost‐effectiveness ,medicine ,Humans ,Economic impact analysis ,health care economics and organizations ,Retrospective Studies ,Chemotherapy ,business.industry ,Haematological Malignancy ,Mortality rate ,Remission Induction ,Hematopoietic Stem Cell Transplantation ,Hematology ,Genomics ,Middle Aged ,Surgery ,Transplantation ,Leukemia, Myeloid, Acute ,Treatment Outcome ,genomic analysis ,030220 oncology & carcinogenesis ,first remission treatment ,Quality-Adjusted Life Years ,Myeloid leukaemia ,business ,030215 immunology ,Research Paper - Abstract
Summary Acute Myeloid Leukaemia (AML) is a rare but serious group of diseases that require critical decision-making for curative treatment. Over the past decade, scientific discovery has revealed dozens of prognostic gene mutations for AML while sequencing costs have plummeted. In this study, we compared the cost-effectiveness of multigene integrative analysis (genomic analysis) with the standard molecular testing currently used for diagnosis of intermediate-risk AML. We used a decision analytic model with data for costs and outcomes from British Columbia, Canada, to assess the long-term (10-year) economic impacts. Our results suggest that genomic analysis would result in a 26% increase in the use of first-remission allogeneic stem cell transplantation. The resulting treatment decisions and downstream effects would come at an additional cost of $12 556 [2013 Canadian dollars (CAD)] per person and the incremental cost-effectiveness ratio would be $49 493 per quality-adjusted life-year gained. Cost-effectiveness was dependent on quality of life during the long-term (5–10) years of survival, relapse rates following first-remission chemotherapy and the upfront cost of transplantation. Non-relapse mortality rates, short-term quality of life and the cost of genomic sequencing had only minor impacts. Further research on post-remission outcomes can lead to improvements in the cost-effectiveness of curative treatments for AML.
- Published
- 2022
4. Krónikus myeloid leukaemia miatt 2003 és 2019 között a Semmelweis Egyetem Belgyógyászati és Onkológiai Klinikáján kezelt betegek adatainak elemzése
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Ágnes Kárpáti, Zsolt Nagy, Júlia Weisinger, Richárd Kiss, Ilona Tárkányi, Judit Csomor, Ambrus Gángó, Botond Timár, Csaba Bödör, Eid Hanna, and Judit Demeter
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Oncology ,medicine.medical_specialty ,business.industry ,Myeloid leukemia ,General Medicine ,Treatment results ,medicine.disease ,Patient population ,Internal medicine ,Major Molecular Response ,medicine ,Overall survival ,Retrospective analysis ,Myeloid leukaemia ,business ,Progressive disease - Abstract
Összefoglaló. Bevezetés: A krónikus myeloid leukaemia a diagnosztika fejlődésének és a tirozin-kináz-gátlók bevezetésének köszönhetően az elmúlt évtizedekben kiváló prognózisú betegséggé vált. Célkitűzés: A betegséggel kapcsolatos ismereteink nagy része klinikai vizsgálatokból származik, emiatt kiemelt szerepük van a nem szelektált beteganyagon végzett elemzéseknek. Módszer: Retrospektív elemzésünkben a Semmelweis Egyetem Belgyógyászati és Onkológiai Klinikáján 2003 és 2019 között tirozin-kináz-gátló kezelésben részesült betegek adatait tekintettük át. Eredmények: Klinikánkon összesen 88 beteg részesült terápiában, közülük 73 beteg az analízis időpontjában is kezelés alatt állt. A betegek 5 éves össztúlélése 86%, 5 éves progressziómentes túlélése 70% volt. 9 beteg halt meg, közülük 2 betegnél a halál oka a progrediáló alapbetegség volt. 38 betegnél volt szükség az első vonalban terápiaváltásra, a váltás oka akkor elsősorban az elégtelen terápiás válasz volt. A későbbi terápiaváltásokra elsősorban intolerancia miatt került sor. Az első vonalban a betegek több mint fele major molekuláris választ ért el, a jelenlegi kezelés mellett a betegek 85%-ánál major molekuláris választ detektáltunk. Megbeszélés: Adataink alapján az intézményünkben kezelt betegek túlélése és a betegek által elért terápiás válasz megfelel a nemzetközi adatoknak. Következtetés: Mivel nem válogatott beteganyagról van szó, a kapott eredmények pontosabb képet adhatnak a krónikus myeloid leukaemia tirozin-kináz-gátlóval történt kezelésének eredményeiről. Orv Hetil. 2021; 162(32): 1297–1302. Summary. Introduction: As a result of advances in diagnostic techniques and the introduction of tyrosine kinase inhibitors, the prognosis of chronic myeloid leukemia has improved over the last decades. Objective: Most of our knowledge about chronic myeloid leukemia results from clinical trials, therefore data derived from non-selected patient population is substantial. Method: Data of chronic myeloid leukemia patients treated with tyrosine kinase inhibitors at the Department of Internal Medicine and Oncology, Semmelweis University, between 2003 and 2019 were analysed retrospectively. Results: 88 patients received treatment, 73 patients were on therapy at the time of the analysis. Overall survival at 5 years was 86%, progression-free survival at 5 years was 70%. 9 patients died, 2 of them due to progressive disease. 38 patients needed 2nd line therapy, the main reason of treatment change was failure of therapy. Subsequent treatment modifications were conducted mostly because of intolerance. More than half of the patients on 1st line treatment reached major molecular response and 85% of the patients on treatment at the end of the analysis are in major molecular response. Discussion: Based on our data, survival and therapeutic response of patients in our center are similar to the international results. Conclusion: This analysis provides real-world data about treatment results of chronic myeloid leukemia in the tyrosine kinase inhibitor era. Orv Hetil. 2021; 162(32): 1297–1302.
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- 2021
5. De novo isolated myeloid sarcoma: comparative analysis of survival in 19 consecutive cases
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Curtis A. Hanson, Mark R. Litzow, Alexandra P. Wolanskyj, Aref Al-Kali, Mrinal M. Patnaik, William J. Hogan, Michelle A. Elliott, Naseema Gangat, Jaya Kittur, Animesh Pardanani, Matthew T. Howard, C. Christopher Hook, Kebede H. Begna, Ayalew Tefferi, Jennifer C. Yui, and Rhett P. Ketterling
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Adult ,Male ,Oncology ,medicine.medical_specialty ,medicine.medical_treatment ,Abnormal Karyotype ,Context (language use) ,Kaplan-Meier Estimate ,Transplantation, Autologous ,law.invention ,Neoplasms, Multiple Primary ,Intramedullary rod ,Young Adult ,Bone Marrow ,Recurrence ,law ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Myeloid sarcoma ,Humans ,Medicine ,Sarcoma, Myeloid ,Aged ,Skin ,Aged, 80 and over ,Risk status ,Chemotherapy ,business.industry ,Hematopoietic Stem Cell Transplantation ,Neoplasms, Second Primary ,Hematology ,Middle Aged ,Neoplastic Cells, Circulating ,medicine.disease ,Gastrointestinal Tract ,Leukemia, Myeloid, Acute ,Treatment Outcome ,medicine.anatomical_structure ,Female ,Bone marrow ,Myeloid leukaemia ,business - Abstract
Institutional database search (1999-2020) for acute myeloid leukaemia (AML) identified 109 cases of myeloid sarcoma (MS), of which 19 were isolated and presented de novo. The latter displayed longer survival (median 78 months), compared to MS with synchronous intramedullary AML (n = 32; median 16 months) and de novo AML without MS (n = 729; median 22 months; P = 0·13). However, the difference in survival was no longer apparent after accounting for bone marrow cytogenetic risk status (P = 0·67). Treatment-induced MS tumour resolution was not affected by the presence of intramedullary disease (P = 0·61). The current study clarifies the prognosis of de novo isolated MS, in the context of AML.
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- 2021
6. A krónikus myeloid leukaemia tirozin-kináz-gátló kezelésének mellékhatásai és azok gyakorlati ellátása
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Gabriella Mezei, Árpád Illés, and Péter Batár
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medicine.medical_specialty ,ABL ,Myeloid ,Side effect ,business.industry ,medicine.drug_class ,breakpoint cluster region ,Myeloid leukemia ,General Medicine ,Gastroenterology ,Tyrosine-kinase inhibitor ,medicine.anatomical_structure ,Internal medicine ,Medicine ,Myeloid leukaemia ,business ,Tyrosine kinase - Abstract
Összefoglaló. A krónikus myeloid leukaemia ritka, klonális őssejt eredetű betegség. A myeloid sejtsor kóros működését a 9-es és 22-es kromoszómák reciprok transzlokációja következtében kialakuló fúziós gén (BCR/ABL1) által kódolt patológiás (fokozott) aktivitású tirozin-kináz jelátviteli fehérje okozza. A tartós, gyakran élethosszig tartó BCR/ABL1 specifikus tirozin-kináz-gátló (TKI-) kezelés a betegek jelentős hányadában az egészséges populáció túlélését elérő teljes gyógyulást biztosít, melyhez folyamatos, a mindenkori szakmai ajánlásoknak megfelelő onkohematológiai ellenőrzés szükséges. Az igen hatékony TKI-kezelés mellett azonban nemkívánatos mellékhatások jelentkezhetnek, melyek – számos szervrendszert érintve – a krónikus myeloid leukaemiás beteg kezelését multidiszciplináris együttműködéssé szélesítik ki. Jelenleg Magyarországon ötféle TKI érhető el, melyek mellékhatásprofilja igen eltérő. A kezelés elindításakor, illetve terápiamódosítás esetén beteg- és kórképspecifikus szempontokat mérlegelve kell kiválasztani az adott TKI-kezelést. Tekintettel a tartós kezelés mellett elérhető kiváló túlélési eredményekre, egyre gyakoribb azoknak a krónikus myeloid leukaemiás betegeknek a száma, akiknél változó súlyosságú nemkívánatos mellékhatások jelentkeznek, melyek miatt a betegek sokszor nem a hematológus szakorvosnál jelentkeznek. A leggyakrabban észlelt szövődmények ismertetését saját beteganyagunk részletes elemzése kapcsán a mindennapi klinikai gyakorlatban is bemutatjuk. Igen fontos, hogy a társszakmák (háziorvos, belgyógyász, kardiológus, angiológus, diabetológus, tüdőgyógyász, gasztroenterológus stb.) gyakorlói is tisztában legyenek az adott TKI-kezelés lehetséges mellékhatásaival, azok megelőzésével, időben történő felismerésével és hatékony kezelésével. Szakmai közreműködésük révén így segíthetik a klinikai hematológust a megfelelő terápia megtervezésében, valamint a betegek folyamatos kezelése kapcsán gyakran szükségessé váló szakmaspecifikus gondozásában is. Orv Hetil. 2021; 162(30): 1198–1207. Summary. Chronic myeloid leukemia is a rare clonal stem cell disorder. The pathological overproduction of the myeloid cell line is caused by abnormal function of a tyrosine kinase encoded by a fusion gene (BCR/ABL1) which is formed upon a reciprocal translocation of chromosomes 9 and 22. Long-term, often lifelong treatment with BCR/ABL1-specific tyrosine kinase inhibitors provides excellent disease control and overall survival rates close to the general survival of a healthy population in a significant proportion of patients. These patients require continuous oncohematological monitoring in accordance with the current diagnostic and treatment guidelines. However, undesirable side effects may occur that extend the treatment of the patients to a multidisciplinary approach involving a number of nonhematological specialities. Currently, five types of tyrosine kinase inhibitors are available in Hungary, with very different side effect profiles. At the start of treatment or in the event of a change in therapy, patient- and leukemia-specific assessments should be taken to select the most proper tyrosine kinase inhibitors treatment. Given the excellent survival outcomes achieved with long-term tyrosine kinase inhibitor treatment, there is an increasing number of patients who might experience adverse events of different kind or severity, which often results in patients ending up in different, nonhematological medical situations. The description of the most frequently observed complications in connection with a detailed cross-sectional analysis of our own patient cohort is also presented here resembling everyday clinical practice. It is very important that practitioners of other medical professions (general practitioner, internist, cardiologist, angiologist, diabetologist, pulmonologist, gastroenterologist, etc.) should be aware of the possible side effects of specific tyrosine kinase inhibitor therapies. They can help to assist the clinical hematologist in planning the appropriate tyrosine kinase inhibitor therapy as well as in professional caretaking of these patients. Orv Hetil. 2021; 162(30): 1198–1207.
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- 2021
7. Association of MEG3 Hypermethylation and MiR-21 Upregulation with the Incidence in Iraqi Acute Myeloid Leukaemia Patients
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Noha Mohammed Saleh and Hameed Majeed Jasim
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Oncology ,MEG3 ,medicine.medical_specialty ,business.industry ,Cognitive Neuroscience ,Incidence (epidemiology) ,Atomic and Molecular Physics, and Optics ,Developmental Neuroscience ,Downregulation and upregulation ,hemic and lymphatic diseases ,Internal medicine ,DNA methylation ,medicine ,Myeloid leukaemia ,business - Abstract
Background: Acute myeloid leukaemia (AML) can be defined as a hematologic malignancy that distinguished by genetic defects and epigenetics alterations. LncRNA MEG3 was shown to play the role of tumour suppressor, and play a pivotal role in leukemogenesis, MEG3 hypermethylation has been reported to be related to different types of haematological malignancies. MIR-21 is regarded as a significant miRNA, it considered to play a vital role in AML progressions. Results: The levels of methylation in the MEG3 promoter region in AML patients were significantly increased than in healthy controls, as the MEG3 expression levels were significantly lowered (P ≤ 0.05) in AML patients in contrast with healthy controls. On the other hand, results showed elevated expression levels of miR-21 in AML patients compared with healthy controls. Conclusion: The present study indicates that the hypermethylation of MEG-3 promoter region could explain MEG-3 expression level loss. Our findings also revealed that the overexpression of miR-21 supports its function as an oncogene.
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- 2021
8. Prognostic effect of gender on outcome of treatment for adults with acute myeloid leukaemia
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Elisabeth Paietta, Zhuoxin Sun, Peter H. Wiernik, Larry D. Cripe, Martin S. Tallman, Mark R. Litzow, Hugo F. Fernandez, Selina M. Luger, Jacob M. Rowe, and Hillard M. Lazarus
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Male ,Oncology ,medicine.medical_specialty ,Prognostic variable ,Daunorubicin ,Kaplan-Meier Estimate ,Disease-Free Survival ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Pharmacokinetics ,White blood cell ,Internal medicine ,Humans ,Medicine ,In patient ,neoplasms ,business.industry ,Disease Management ,Hematology ,Prognosis ,Survival Analysis ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Acute promyelocytic leukaemia ,Myeloid leukaemia ,business ,030215 immunology ,Hormone ,medicine.drug - Abstract
There are conflicting reports in the literature suggesting that one gender or the other has a better survival with acute myeloid leukaemia (AML). The present study was done in an attempt to resolve the issue. The effect of gender was examined on 3546 newly diagnosed patients with AML, including 548 patients with acute promyelocytic leukaemia (APL) enrolled in 10 multi-institutional treatment studies from March 1984 to November 2008. Kaplan-Meier estimates were used to estimate event-time distributions for survival and multivariate models were used to examine the gender effect after adjusting for multiple risk factors. P values were based on two-sided tests. Non-APL female patients had a significantly better overall (OS) but not disease-free survival (DFS) than males, irrespective of age, initial white blood cell count, or dose of daunorubicin. No differences were observed for obese or FMS-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD)-positive patients. Female patients with APL had a significantly better OS and DFS than male patients with APL, and differences in survival were greater for patients with t(15;17) + other cytogenetic abnormalities compared with those with t(15;17) only. Gender is an independent prognostic variable in patients with AML. Whether these survival differences are due to hormonal, genetic or pharmacokinetic differences between the sexes or differential toxin exposure such as smoking is unknown. However, the former seems less likely as patient age did not influence the survival advantage for female patients.
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- 2021
9. Biomarkers to predict infection and infection-related complications during chemotherapy-induced neutropenia in acute myeloid leukaemia: a pilot study
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Gerard van Mierlo, Judith Zandstra, Annemarie van de Geer, Ilse Jongerius, Efran Nur, Michael W.T. Tanck, Sacha Zeerleder, Taco W. Kuijpers, Robin van Bruggen, Pediatrics, Hematology, Graduate School, General Paediatrics, ACS - Pulmonary hypertension & thrombosis, AII - Infectious diseases, Epidemiology and Data Science, APH - Methodology, Clinical Haematology, Landsteiner Laboratory, Paediatric Infectious Diseases / Rheumatology / Immunology, CCA - Imaging and biomarkers, ACS - Atherosclerosis & ischemic syndromes, and Amsterdam Reproduction & Development (AR&D)
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Oncology ,medicine.medical_specialty ,business.industry ,Hematology ,030204 cardiovascular system & hematology ,Neutropenia ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,febrile neutropenia ,Chemotherapy induced ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Biomarker (medicine) ,biomarker ,acute myeloid leukaemia ,Myeloid leukaemia ,610 Medicine & health ,business ,Febrile neutropenia - Published
- 2021
10. Peripheral blood molecular measurable residual disease is sufficient to identify patients with acute myeloid leukaemia with imminent clinical relapse
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Kristian Løvvik Juul-Dam, Henrik Hasle, Anne-Sofie Skou, and Hans Beier Ommen
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Oncology ,measurable residual disease ,medicine.medical_specialty ,Neoplasm, Residual ,Oncogene Proteins, Fusion ,quantitative polymerase chain reaction ,Disease ,Real-Time Polymerase Chain Reaction ,Sensitivity and Specificity ,03 medical and health sciences ,European LeukemiaNet ,0302 clinical medicine ,Bone Marrow ,Predictive Value of Tests ,Recurrence ,pre-emptive therapy ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Biomarkers, Tumor ,Humans ,Medicine ,acute myeloid leukaemia ,RNA, Messenger ,RNA, Neoplasm ,molecular relapse ,business.industry ,Remission Induction ,Complete remission ,Hematology ,Neoplastic Cells, Circulating ,Peripheral blood ,body regions ,Leukemia, Myeloid, Acute ,Early Diagnosis ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Treatment strategy ,RNA, Long Noncoding ,Bone marrow ,Myeloid leukaemia ,business ,Nucleophosmin ,030215 immunology - Abstract
Longitudinal molecular measurable residual disease (MRD) sampling after completion of therapy serves as a refined tool for identification of imminent relapse of acute myeloid leukaemia (AML) among patients in long-term haematological complete remission. Tracking of increasing quantitative polymerase chain reaction MRD before cytomorphological reappearance of blasts may instigate individual management decisions and has paved the way for development of pre-emptive treatment strategies to substantially delay or perhaps even revert leukaemic regrowth. Traditionally, MRD monitoring is performed using repeated bone marrow aspirations, albeit the current European LeukemiaNet MRD recommendations acknowledge the use of peripheral blood as an alternative source for MRD assessment. Persistent MRD positivity in the bone marrow despite continuous morphological remission is frequent in both core binding factor leukaemias and nucleophosmin 1-mutated AML. In contrast, monthly assessment of MRD in peripheral blood superiorly separates patients with imminent haematological relapse from long-term remitters and may allow pre-emptive therapy of AML relapse.
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- 2021
11. Second allogeneic haematopoietic cell transplantation using HLA‐matched unrelated versus T‐cell replete haploidentical donor and survival in relapsed acute myeloid leukaemia
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Matthias Edinger, Arnold Ganser, Annalisa Ruggeri, Martin Gramatzki, Arnon Nagler, Myriam Labopin, Patrice Chevallier, Nicolaus Kröger, Eolia Brissot, Didier Blaise, Bipin N. Savani, Fabio Ciceri, Jürgen Finke, Mohamed A. Kharfan-Dabaja, Jaime Sanz, Matthias Stelljes, Eric Deconinck, Mohamad Mohty, Kharfan-Dabaja, M. A., Labopin, M., Brissot, E., Kroger, N., Finke, J., Ciceri, F., Deconinck, E., Blaise, D., Chevallier, P., Gramatzki, M., Ganser, A., Stelljes, M., Edinger, M., Savani, B., Ruggeri, A., Sanz, J., Nagler, A., Mohty, M., Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
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Adult ,Male ,Oncology ,medicine.medical_specialty ,T-Lymphocytes ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Human leukocyte antigen ,second allogeneic haematopoietic cell transplant ,Disease-Free Survival ,Lymphocyte Depletion ,03 medical and health sciences ,0302 clinical medicine ,HLA Antigens ,Interquartile range ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,acute myeloid leukaemia ,ComputingMilieux_MISCELLANEOUS ,Retrospective Studies ,relapse ,Acute leukemia ,business.industry ,Histocompatibility Testing ,Hazard ratio ,Hematopoietic Stem Cell Transplantation ,[SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy ,Hematology ,Middle Aged ,Allografts ,Haploidentical Donor ,Confidence interval ,Survival Rate ,Leukemia, Myeloid, Acute ,Haematopoiesis ,030220 oncology & carcinogenesis ,Female ,Myeloid leukaemia ,Unrelated Donors ,business ,030215 immunology - Abstract
Optimal donor choice for a second allogeneic haematopoietic cell transplant (allo-HCT) in relapsed acute myeloid leukaemia (AML) remains unknown. We compared overall survival (OS) using registry data from the Acute Leukemia Working Party (ALWP) of the European Society for Blood and Marrow Transplantation (EBMT) involving 455 adults who received a second allo-HCT from a human leucocyte antigen (HLA)-matched unrelated (MUD) (n = 320) or a haploidentical (n = 135) donor. Eligibility criteria required adults aged >= 18 years who received a second allo-HCT for treating AML relapse between 2005 and 2019. The primary end-point was OS. There was no statistically significant difference in the median (interquartile range) age between the groups, MUD 46 (35-58) versus haploidentical 44 (33-53) years (P = 0 center dot 07). The median OS was not different between the MUD and the haploidentical groups (10 vs. 11 months, P = 0 center dot 57). Similarly, the 2-year OS was 31% for the MUD and 29% for the haploidentical donor groups. The OS was worse if the procedure was performed with active AML [hazard ratio (HR) 1 center dot 42, 95% confidence interval (CI) 1 center dot 07-1 center dot 89; P = 0 center dot 02]. Conversely, a longer time from first allo-HCT to relapse (>13 center dot 2 months) was associated with better OS (HR 0 center dot 50, 95% CI 0 center dot 37-0 center dot 69; P < 0 center dot 0001). The results of the present analysis limit the ability to recommend one donor type over another when considering a second allo-HCT for relapsed AML. Our findings highlight that best OS is achieved when receiving the second allo-HCT in complete remission.
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- 2021
12. The factors influencing clinical outcomes after leukapheresis in acute leukaemia
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Myungshin Kim, Jaeeun Yoo, Yonggoo Kim, Jae-Ho Yoon, Dong Wook Jekarl, Kyoung Bo Kim, Dong-Wook Kim, Howon Lee, Seok Lee, Byung-Sik Cho, Hee-Je Kim, Jihyang Lim, Silvia Park, Nack-Gyun Chung, Bin Cho, Eun-Jee Oh, and Hyojin Chae
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Adolescent ,Science ,Comorbidity ,030204 cardiovascular system & hematology ,Article ,Acute myeloid leukaemia ,World health ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,CEBPA ,medicine ,Humans ,Leukapheresis ,Mortality ,Aged ,Aged, 80 and over ,Acute lymphocytic leukaemia ,Multidisciplinary ,business.industry ,Confounding ,Middle Aged ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,Survival Analysis ,Confidence interval ,Leukemia, Myeloid, Acute ,Platelet transfusion ,030220 oncology & carcinogenesis ,CCAAT-Enhancer-Binding Proteins ,Lymphoblastic leukaemia ,Medicine ,Female ,Myeloid leukaemia ,business - Abstract
Leukapheresis is used for the mechanical removal of leukaemic cells in hyperleukocytosis. However, the effectiveness of leukapheresis remains unclear due to selection and confounding factors in the cohorts. We compared the effectiveness of leukapheresis among the subgroups according to either the 2016 World Health Organization classification or the number of cytogenetic abnormalities with a retrospective, single-centre study from January 2009 to December 2018. Acute myeloid leukaemia (AML, n = 212) and acute lymphoblastic leukaemia (ALL, n = 97) were included. The 30-day survival rates (95% confidence interval, 95% CI) for AML and ALL were 86.3% (81.6–90.9%) and 94.8% (90.3–99.2%), respectively. For AML, ‘primary AML with myelodysplasia-related changes’ and ‘AML with biallelic mutation of CEBPA’ showed better 30-day survival outcomes (P = 0.026) than the other subgroups. A higher platelet count after leukapheresis was associated with better 30-day survival in AML patients (P = 0.029). A decrease in blast percentage count after leukapheresis was associated with better 30-day survival in ALL patients (P = 0.034). Our study suggested that prophylactic platelet transfusion to raise the platelet count to 50 × 109/L or greater might improve clinical outcome in AML patients undergoing leukapheresis.
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- 2021
13. Outcomes of patients with chronic myelomonocytic leukaemia treated with non-curative therapies
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Klaus Geissler, Athina-Nora Viniou, Blanca Xicoy Cirici, Peter Valent, Alexandra Kourakli, Ulrich Germing, Jennifer Kaivers, Christoforos Roubakis, Johanna Ungerstedt, Lisa Pleyer, Guillermo Sanz, Sonja Heibl, Mikkael A. Sekeres, Maria Julia Montoro, Bhumika J. Patel, Marisa Calabuig Muñoz, Anthony M. Hunter, Eric Padron, Jaroslav Cermak, Peristera Patiou, Nicolas Bonadies, Teresa Bernal del Castillo, Jaroslaw P. Maciejewski, Antonio Almeida, Eva Hellstroem-Lindberg, Richard Greil, Andres Jerez, Alejandro Avendaño Pita, Elvira Mora, Alexander Egle, Athanasios Galanopoulos, Montserrat Arnan, Alan F. List, B. Andrade, Maria Dimou, Argiris Symeonidis, Maria-José Jimenez Lorenzo, Albert Cortés, Julian Larcher-Senn, Thomas Melchardt, and Michael Leisch
- Subjects
Male ,medicine.medical_specialty ,Antineoplastic Agents ,Disease ,Time to next treatment ,Kaplan-Meier Estimate ,Myelomonocytic leukaemia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Humans ,Hydroxyurea ,610 Medicine & health ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Myelodysplastic syndromes ,Hazard ratio ,Retrospective cohort study ,Leukemia, Myelomonocytic, Chronic ,Hematology ,Middle Aged ,medicine.disease ,Prognosis ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Azacitidine ,Female ,Bone marrow ,Myeloid leukaemia ,business ,030215 immunology - Abstract
BACKGROUND: Approval of hypomethylating agents in patients with chronic myelomonocytic leukaemia is based on trials done in patients with myelodysplastic syndromes. We aimed to investigate whether hypomethylating agents provide a benefit in subgroups of patients with chronic myelomonocytic leukaemia compared with other treatments. METHODS: For this retrospective cohort study, data were retrieved between Nov 30, 2017, and Jan 5, 2019, from 38 centres in the USA and Europe. We included non-selected, consecutive patients diagnosed with chronic myelomonocytic leukaemia, who received chronic myelomonocytic leukaemia-directed therapy. Patients with acute myeloid leukaemia according to 2016 WHO criteria at initial diagnosis (ie, =20% blasts in the bone marrow or peripheral blood) or with unavailability of treatment data were excluded. Outcomes assessed included overall survival, time to next treatment, and time to transformation to acute myeloid leukaemia. Analyses were adjusted by age, sex, platelet count, and Chronic myelomonocytic leukaemia-Specific Prognostic Scoring System (CPSS). Patients were grouped by first received treatment with either hydroxyurea, hypomethylating agents, or intensive chemotherapy, and stratified by risk according to blast count, French-American-British subtype, CPSS, WHO 2016 subtype, and the eligibility criteria of the DACOTA trial (NCT02214407). FINDINGS: 949 patients diagnosed with chronic myelomonocytic leukaemia between April 13, 1981, and Oct 26, 2018, were included. Median follow-up was 23·4 months (IQR 11·5-42·3) from diagnosis and 16·2 months (6·6-31·6) from start of first-line treatment. 412 (43%) of 949 patients received hypomethylating agents as first treatment, 391 (41%) hydroxyurea, and 83 (9%) intensive chemotherapy. Adjusted median overall survival for patients treated with hydroxyurea versus hypomethylating agents was 15·6 months (95% CI 13·1-17·3) versus 20·7 months (17·9-23·4); hazard ratio (HR) 1·39 (1·17-1·65; p=0·0002) and 14·0 months (9·8-17·2) versus 20·7 months (17·9-23·4; HR 1·55 [1·16-2·05]; p=0·0027) for those treated with intensive chemotherapy versus hypomethylating agents. In patients with myeloproliferative chronic myelomonocytic leukaemia (myeloproliferative CMML), median overall survival was 12·6 months (10·7-15·0) versus 17·6 months (14·8-21·5; HR 1·38 [1·12-1·70]; p=0·0027) for patients treated with hydroxyurea versus hypomethylating agents, and 12·3 months (8·4-16·6) versus 17·6 months (14·8-21·5; HR 1·44 [1·02-2·03]; p=0·040) for intensive chemotherapy versus hypomethylating agents. Hypomethylating agents did not confer an overall survival advantage for patients classified as having lower-risk disease (ie, myelodysplastic chronic myelomonocytic leukaemia with
- Published
- 2021
14. Complete, yet partial: the benefits of complete response with partial haematological recovery as an endpoint in acute myeloid leukaemia clinical trials
- Author
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Rory M. Shallis, Daniel A. Pollyea, and Amer M. Zeidan
- Subjects
Oncology ,Clinical Trials as Topic ,medicine.medical_specialty ,business.industry ,Remission Induction ,Hematology ,Prognosis ,Blood Cell Count ,Hematopoiesis ,Survival Rate ,Clinical trial ,Leukemia, Myeloid, Acute ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Myeloid leukaemia ,business ,Complete response - Published
- 2020
15. CLAG-M chemotherapy followed by umbilical cord blood stem cell transplantation for primary refractory acute myeloid leukaemia in a child: A case report
- Author
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Liucheng Rong, Yao Xue, Yongjun Fang, Jun Zhu, Jie Huang, and Xiaoyun Yang
- Subjects
Oncology ,Chemotherapy ,medicine.medical_specialty ,CLAG-M protocol ,child ,Refractory ,business.industry ,medicine.medical_treatment ,Salvage therapy ,General Medicine ,Umbilical Cord Blood Stem Cell Transplantation ,Acute myeloid leukaemia ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,hemic and lymphatic diseases ,Case report ,medicine ,030211 gastroenterology & hepatology ,Myeloid leukaemia ,business - Abstract
BACKGROUND The prognosis of paediatric primary refractory/relapsed acute myeloid leukaemia (R/R AML) remains poor. Intensive therapy is typically used as salvage treatment for those with R/R AML. No data are currently available about the use of the CLAG-M protocol as salvage therapy in paediatric patients with R/R AML. CASE SUMMARY An 8-year-old patient was diagnosed with acute myeloid leukaemia by bone marrow morphology and immunophenotype. The patient showed poor response to two cycles of induction therapy with 60% blast cells in the bone marrow after the second induction cycle. The patient achieved complete remission after being treated with the CLAG-M protocol as salvage therapy before undergoing umbilical cord blood stem cell transplantation. Morphological complete remission with haematological recovery has hitherto been maintained over 4 mo. Abnormal gene mutations detected at diagnosis were undetectable after haematopoietic stem cell transplantation. CONCLUSION Here we present a paediatric patient with primary refractory acute myeloid leukaemia who was successfully treated with the CLAG-M protocol. Given the positive results of the presented patient, large-scale clinical studies are required to assess the role of the CLAG-M protocol in the salvage treatment of refractory or relapsed AML in childhood.
- Published
- 2020
16. Childhood core binding factor (CBF) acute myeloid leukemia and its association with French American British (FAB) classification
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Syed Ahmer Hamid, Naeem Jabbar, Sidra Maqsood, Zaid Muhammad Aslam, Neelum Mansoor, and Anzal Taufeeq Jangda
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Male ,Oncology ,medicine.medical_specialty ,Adolescent ,Population ,Core binding factor ,Leukocyte Count ,Internal medicine ,medicine ,Humans ,Child ,education ,Retrospective Studies ,education.field_of_study ,business.industry ,Core Binding Factors ,Significant difference ,Infant ,Myeloid leukemia ,Mean age ,Retrospective cohort study ,General Medicine ,Core binding factor acute myeloid leukaemia ,Prognosis ,United States ,Leukemia, Myeloid, Acute ,Child, Preschool ,Female ,Myeloid leukaemia ,business - Abstract
Objective: To find the frequency of core binding factor acute myeloid leukaemia in our population, and to determine its association with morphological subtypes. Methods: The retrospective study was conducted at The Indus Hospital, Karachi, and comprised data of patients aged 1-17 years who were diagnosed with acute myeloid leukaemia from July 2013 to June 2017. Data was analysed using SPSS 21. Results: Of the 237 patients, 137(58%) were males and 100(42%) were females. The overall mean age was 8±4.34 years. Cytogenetic testing had been performed in 212(89.45%) cases, and core binding factor was detected in 72(34%) cases. There was significant difference between the mean values of white cell count and the subtypes (p=0.000). Also the difference between core binding factor and the subtypes was significant (p=0.000). Conclusion: There was found to be a significant association of core binging factor with specific subgroups of acute myeloid leukaemia. Key Words: Acute myeloid leukaemia, Core binding factor, Cytogenetic abnormalities, Prognosis. Continuous....
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- 2020
17. Acceptability of pharmacist-led interventions to resolve drug-related problems in patients with chronic myeloid leukaemia
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Siew Siang Chua, Sharmini Balashanker, Kian Meng Chang, Li-Chia Chen, Ping Chong Bee, and Bee Kim Tan
- Subjects
Drug ,medicine.medical_specialty ,Drug-Related Side Effects and Adverse Reactions ,medicine.drug_class ,media_common.quotation_subject ,Pharmacist ,Psychological intervention ,Pharmacists ,Chronic myeloid leukaemia ,Tyrosine-kinase inhibitor ,03 medical and health sciences ,0302 clinical medicine ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,In patient ,Pharmacist intervention ,media_common ,business.industry ,Pharmaceutical Preparations ,Oncology ,Pharmaceutical Services ,030220 oncology & carcinogenesis ,Myeloid leukaemia ,business ,030215 immunology - Abstract
Purpose Chronic myeloid leukaemia (CML) patients on long-term tyrosine kinase inhibitor (TKI) therapy are susceptible to drug-related problems (DRPs). This study aimed to evaluate the acceptability and outcomes of pharmacist-led interventions on DRPs encountered by CML patients. Methods This study included participants from the intervention arm of a randomised controlled trial which was conducted to evaluate the effects of pharmacist-led interventions on CML patients treated with TKIs. Participants were recruited and followed up in the haematology clinics of two hospitals in Malaysia from March 2017 to January 2019. A pharmacist identified DRPs and helped to resolve them. Patients were followed-up for six months, and their DRPs were assessed based on the Pharmaceutical Care Network Europe Classification for DRP v7.0. The identified DRPs, the pharmacist’s interventions, and the acceptance and outcomes of the interventions were recorded. A Poisson multivariable regression model was used to analyse factors associated with the number of identified DRPs per participant. Results A total of 198 DRPs were identified from 65 CML patients. The median number of DRPs per participants was 3 (interquartile range: 2, 4). Most participants (97%) had at least one DRP, which included adverse drug events (45.5%), treatment ineffectiveness (31.5%) and patients’ treatment concerns or dissatisfaction (23%). The 228 causes of DRPs identified comprised the following: lack of disease or treatment information, or outcome monitoring (47.8%), inappropriate drug use processes (23.2%), inappropriate patient behaviour (19.9%), suboptimal drug selection (6.1%), suboptimal dose selection (2.6%) and logistic issues in dispensing (0.4%). The number of concomitant medications was significantly associated with the number of DRPs (adjusted Odds Ratio: 1.100; 95% CI: 1.005, 1.205; p = 0.040). Overall, 233 interventions were made. These included providing patient education on disease states or TKI-related side effects (75.1%) and recommending appropriate instructions for taking medications (7.7%). Of the 233 interventions, 94.4% were accepted and 83.7% were implemented by the prescriber or patient. A total of 154 DRPs (77.3%) were resolved. Conclusions The pharmacist-led interventions among CML patients managed to identify various DRPs, were well accepted by both TKI prescribers and patients, and had a high success rate of resolving the DRPs.
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- 2020
18. The effect of 5‐azacytidine treatment delays and dose reductions on the prognosis of patients with myelodysplastic syndrome: how to optimize treatment results and outcomes
- Author
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Eleftheria Hatzimichael, Argiris Symeonidis, George Vassilopoulos, Athanasios Galanopoulos, Vasiliki Pappa, Panagiotis Zikos, Menelaos-Konstantinos Papoutselis, Alexandra Kourakli, Dimitrios Tsokanas, Marie-Christine Kyrtshonis, Maria Papaioannou, Achilles Anagnostopoulos, Maria Kotsopoulou, Maria Dimou, Helen A. Papadaki, Aekaterini Megalakaki, Nora-Athina Viniou, Panagiotis T. Diamantopoulos, Panagiotis Repousis, Panayiotis Panayiotidis, Charalampos Pontikoglou, Sotirios G. Papageorgiou, Elena E. Solomou, Ioannis Kotsianidis, and Georgios Dryllis
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Neutropenia ,Treatment results ,Disease-Free Survival ,Time-to-Treatment ,Internal medicine ,medicine ,Humans ,Registries ,Aged ,Retrospective Studies ,Aged, 80 and over ,Drug Tapering ,business.industry ,Hazard ratio ,Complete remission ,Hematology ,Middle Aged ,Prognosis ,medicine.disease ,Survival Rate ,Regimen ,International Prognostic Scoring System ,Myelodysplastic Syndromes ,Azacitidine ,Female ,National registry ,Myeloid leukaemia ,business - Abstract
The regimen of 5-azacytidine for patients with myelodysplastic syndrome (MDS) has remained unchanged since its first approval. Although several modifications have since been made and delays and dose reductions are common especially during the first treatment cycles, there are minimal data on the prognostic effect of these modifications. In this study, based on data from 897 patients with MDS treated with 5-azacytidine recorded in a national registry, the effect of treatment delays and dose reductions on response, transformation to acute myeloid leukaemia, and survival (after 5-azacytidine initiation, OST ) were analysed. Delays during the first two cycles were noted in 150 patients (16·7%) and were found to adversely affect OST independently of the International Prognostic Scoring System score [hazard ratio (HR), 1·368; P = 0·033] or pre-existing neutropenia (HR, 1·42; P = 0·015). In patients achieving a response, delays before response achievement were correlated with its type (complete remission, 2·8 days/cycle; partial remission, 3·3 days/cycle; haematologic improvement, 5·6 days/cycle; P = 0·041), while delays after response achievement did not have any effect on retention of response or survival. Dose reductions were found to have no prognostic impact. Based on our results, treatment delays especially during the first cycles should be avoided, even in neutropenic patients. This strict strategy may be loosened after achieving a favourable response.
- Published
- 2020
19. Impact of invasive aspergillosis occurring during first induction therapy on outcome of acute myeloid leukaemia (SEIFEM‐12B study)
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Gianpaolo Nadali, Chiara Cattaneo, Rosa Fanci, Luisa Verga, Luana Fianchi, Anna Chierichini, Katia Perruccio, Alessandro Busca, Livio Pagano, Giuseppe Petruzzellis, Bruno Martino, Giulia Dragonetti, Mariagrazia Garzia, Roberta Di Blasi, Marianna Criscuolo, Francesca Farina, Mario Delia, Nicola Vianelli, Maria Elena Zannier, Anna Candoni, and Maria Ilaria Del Principe
- Subjects
Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Antifungal Agents ,AML ,induction chemotherapy ,invasive aspergillosis ,SEIFEM ,030106 microbiology ,Dermatology ,Aspergillosis ,Antileukemic agent ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Mortality ,Risk factor ,Aged ,Cause of death ,Voriconazole ,business.industry ,Remission Induction ,Case-control study ,Induction chemotherapy ,General Medicine ,Middle Aged ,Settore MED/15 ,medicine.disease ,Leukemia, Myeloid, Acute ,Settore MED/15 - MALATTIE DEL SANGUE ,Treatment Outcome ,Infectious Diseases ,Case-Control Studies ,Female ,Myeloid leukaemia ,business ,Invasive Fungal Infections ,medicine.drug - Abstract
BACKGROUND Acute myeloid leukaemia (AML) patients are at high risk of invasive aspergillosis (IA) after first induction chemotherapy (CHT). Although IA risk factors have been identified, few data are available on impact of IA, occurring during induction phase, on overall AML outcome. PATIENTS AND RESULTS The end point of this multicentre, case-control, study was to evaluate whether IA, occurring after first induction CHT, can affect treatment schedule and patient's outcome. We identified 40 AML patients (cases) who developed IA during first induction phase, 31 probable (77.5%) and 9 proven (22.5%). These cases were matched with a control group (80 AML) without IA, balanced according to age, type of CHT, AML characteristics and cytogenetic-molecular risk factors. The overall response rate to induction CHT was the same in the 2 groups. In the 40 cases with IA, the overall response rate to antifungal treatment was favourable (80%) but it was significantly affected by the achievement of leukaemia complete remission (CR) with induction CHT. In fact, in cases with AML responsive to induction CHT, responses of IA to antifungal therapy were 96% compared to 21% in cases of AML not responsive to induction treatment (P
- Published
- 2020
20. Combination treatment with CPX‐351 and midostaurin in patients with secondary acute myeloid leukaemia that areFLT3mutated: three cases and review of literature
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Tracy Murphy, Claire Andrews, Dawn Maze, and Hassan Sibai
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Oncology ,medicine.medical_specialty ,chemistry.chemical_compound ,Combined treatment ,chemistry ,business.industry ,Internal medicine ,medicine ,In patient ,Hematology ,Midostaurin ,Myeloid leukaemia ,business - Published
- 2020
21. Cytogenetic Pattern in Adult Patients with de novo Acute Myeloid Leukaemia: A Single Centre Study in Bangladesh
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Farzana Rahman, Umme Kulsum Munmun, Md. Rafiquzzaman Khan, Md. Abdul Aziz, Shafiqul Islam, Masuda Begum, Saqi Md. Abdul Baqi, and Md. Salahuddin Shah
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Oncology ,medicine.medical_specialty ,NPM1 ,Adult patients ,business.industry ,De novo acute ,Cytogenetics ,Wbc count ,Single centre ,medicine.anatomical_structure ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Bone marrow ,Myeloid leukaemia ,business - Abstract
Background: Cytogenetic analysis performed at diagnosis is considered to be the most important prognostic factor in AML. Objective: The purpose of this study was to observe the pattern of cytogenetic abnormalities in adult patients with de novo AML. Method: Total fifty-two newly diagnosed de novo AML patients were selected for the study. Six cytogenetic abnormalities including t(8;21), t(15;17), inv(16), BCR-ABL1, FLT3-ITD & NPM1 mutations were detected by Real-Time PCR. Results: In this study, 36 (69.2%) patients showed different cytogenetic abnormalities. The t(15;17) was found to be the most common. t(15;17), t(8;21) and inv(16) were found only in M3, M2 and M4 FAB subtypes, respectively. Significant association was found with increasing age and cytogenetic risk groups. BCR-ABL1 mutation showed significant relation with increased age. FLT3-ITD mutation showed significant association with increased WBC count and inv16 was significantly associated with relatively less bone marrow blast percentage. Conclusion: Cytogenetic study should be performed routinely in all cases of AML for proper diagnosis, prediction of prognosis and implementation of effective therapeutic measures.
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- 2020
22. Azacitidine in patients older than 80 years with acute myeloid leukaemia or myelodysplastic syndromes: a report on 115 patients
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Steven Le Gouill, Anne‐Marie Ngo Nloga, Cecile Bally, Thierry Guillaume, Thomas Cluzeau, Anne Calleja, Patrice Chevallier, Pierre Fenaux, Eurydice Angeli, Maxime Jullien, Alice Garnier, Pierre Peterlin, Lionel Ades, and Amandine Le Bourgeois
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Myelodysplastic syndromes ,Azacitidine ,MEDLINE ,Hematology ,medicine.disease ,Internal medicine ,medicine ,In patient ,Myeloid leukaemia ,business ,medicine.drug - Published
- 2020
23. Reducing the red blood cell transfusion threshold from 8·0 g/dl to 7·0 g/dl in acute myeloid leukaemia patients undergoing induction chemotherapy reduces transfusion rates without adversely affecting patient outcome
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Hubert Serve, Gesine Bug, Halvard Bonig, Olivier Ballo, Fabian Finkelmeier, Philine Fleckenstein, Erhard Seifried, Fagr Eladly, Christian Brandts, Eva-Maria Kreisel, Markus Müller, and Jan Stratmann
- Subjects
Male ,medicine.medical_specialty ,Red Blood Cell Transfusion ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,Randomized Controlled Trials as Topic ,business.industry ,Cancer ,Induction chemotherapy ,Induction Chemotherapy ,Hematology ,General Medicine ,Middle Aged ,medicine.disease ,Intensive care unit ,Survival Rate ,Leukemia, Myeloid, Acute ,Red blood cell ,medicine.anatomical_structure ,Practice Guidelines as Topic ,Female ,Myeloid leukaemia ,Erythrocyte Transfusion ,business ,030215 immunology - Abstract
Background and objectives Red blood cell (RBC) transfusions are needed by almost every acute myeloid leukaemia (AML) patient undergoing induction chemotherapy and constitute a cornerstone in supportive measures for cancer patients in general. Randomized controlled trials have shown non-inferiority or even superiority of restrictive transfusion guidelines over liberal transfusion guidelines in specific clinical situations outside of medical oncology. In this study, we analysed whether more restrictive RBC transfusion reduces blood use without affecting hard outcomes. Materials and methods A total of 352 AML patients diagnosed between 2007 and 2018 and undergoing intensive induction chemotherapy were included in this retrospective analysis. In the less restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 8 g/dl (2007-2014). In the restrictive transfusion group, patients received RBC transfusion for haemoglobin levels below 7 g/dl (2016-2018). Liberal transfusion triggers were never endorsed. Results A total of 268 (76·1%) and 84 (23·9%) AML patients fell into the less restrictive and restrictive transfusion groups, respectively. The less restrictive transfusion group had 1 g/dl higher mean haemoglobin levels, received their first RBC transfusions earlier and needed 1·5 more units of RBC during the hospital stay of induction chemotherapy. Febrile episodes, C-reactive protein levels, admission to the intensive care unit, length of hospital stay as well as response and survival rates did not differ between the two cohorts. Conclusion From our retrospective analysis, we conclude that a more restrictive transfusion trigger does not affect important outcomes of AML patients. The opportunity to test possible effects of the more severe anaemia in the restrictive transfusion group on quality of life was missed.
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- 2020
24. Applicability and reproducibility of acute myeloid leukaemia stem cell assessment in a multi‐centre setting
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Gail J. Roboz, Gert J. Ossenkoppele, Sylvie D. Freeman, Maria Irno-Consalvo, Diana Hanekamp, Jacqueline Cloos, Francesco Buccisano, Monica L. Guzman, Marlen Metzner, Angèle Kelder, Michaela Feuring-Buske, Naeem Khan, Vincent H.J. van der Velden, Gerrit Jan Schuurhuis, Willemijn J. Scholten, Harrie Eidhof, Mayumi Sugita, Sjoerd Oude Alink, Costa Bachas, Paresh Vyas, Jennichjen Slomp, Miriam Wilhelm, Anja de Jong, Alexander N. Snel, Edwin Sonneveld, VU University medical center, Hematology laboratory, CCA - Cancer Treatment and quality of life, AII - Cancer immunology, and Immunology
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Haematological malignancy ‐ Biology ,Future risk ,Sample processing ,Population ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Medicine ,Humans ,Multi centre ,education ,education.field_of_study ,Reproducibility ,Hematology ,business.industry ,Settore MED/15 ,Flow Cytometry ,Leukemia, Myeloid, Acute ,030220 oncology & carcinogenesis ,Neoplastic Stem Cells ,Female ,sense organs ,Stem cell ,Myeloid leukaemia ,business ,030215 immunology ,Research Paper - Abstract
Leukaemic stem cells (LSC) have been experimentally defined as the leukaemia-propagating population and are thought to be the cellular reservoir of relapse in acute myeloid leukaemia (AML). Therefore, LSC measurements are warranted to facilitate accurate risk stratification. Previously, we published the composition of a one-tube flow cytometric assay, characterised by the presence of 13 important membrane markers for LSC detection. Here we present the validation experiments of the assay in several large AML research centres, both in Europe and the United States. Variability within instruments and sample processing showed high correlations between different instruments (Rpearson > 0·91, P high (>0·03% LSC) from LSClow (
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- 2020
25. Development and validation of a 10‐gene prognostic signature for acute myeloid leukaemia
- Author
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Tingting Tang, Guoyan Tian, Xiaohui Chen, Zuyi Yang, Ning Li, Liang Zhang, and Jun Shang
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Male ,0301 basic medicine ,Oncology ,Multivariate statistics ,medicine.medical_specialty ,Poor prognosis ,Kaplan-Meier Estimate ,Disease-Free Survival ,nomogram ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Biomarkers, Tumor ,gene expression profiling ,medicine ,Humans ,acute myeloid leukaemia ,Proportional Hazards Models ,Framingham Risk Score ,Prognostic signature ,Proportional hazards model ,business.industry ,Univariate ,Original Articles ,Cell Biology ,Middle Aged ,Nomogram ,Prognosis ,Neoplasm Proteins ,Gene Expression Regulation, Neoplastic ,Leukemia, Myeloid, Acute ,Nomograms ,030104 developmental biology ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Original Article ,Myeloid leukaemia ,Transcriptome ,business ,signature - Abstract
Acute myeloid leukaemia (AML) is the most common type of adult acute leukaemia and has a poor prognosis. Thus, optimal risk stratification is of greatest importance for reasonable choice of treatment and prognostic evaluation. For our study, a total of 1707 samples of AML patients from three public databases were divided into meta‐training, meta‐testing and validation sets. The meta‐training set was used to build risk prediction model, and the other four data sets were employed for validation. By log‐rank test and univariate COX regression analysis as well as LASSO‐COX, AML patients were divided into high‐risk and low‐risk groups based on AML risk score (AMLRS) which was constituted by 10 survival‐related genes. In meta‐training, meta‐testing and validation sets, the patient in the low‐risk group all had a significantly longer OS (overall survival) than those in the high‐risk group (P
- Published
- 2020
26. Detection of measurable residual disease may better predict outcomes than mutations based on next‐generation sequencing in acute myeloid leukaemia with biallelic mutations of CEBPA
- Author
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Xiaohong Liu, Hao Jiang, Lizhong Gong, Ying Wu, Yu Wang, Jing Wang, Guo-Rui Ruan, Lan-Ping Xu, Xiao-Hui Zhang, Hong-Xia Shi, Jinsong Jia, Yue-Yun Lai, Lu Runqing, Sheng-Ye Lu, Xiao-Su Zhao, Kai-Yan Liu, Xiao-Jun Huang, Chen-Hua Yan, and Qian Jiang
- Subjects
Adult ,Male ,Oncology ,medicine.medical_specialty ,Prognostic factor ,Neoplasm, Residual ,Adolescent ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Disease ,Risk Assessment ,DNA sequencing ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,hemic and lymphatic diseases ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,CEBPA ,medicine ,Humans ,Anthracyclines ,Cumulative incidence ,Alleles ,Aged ,Chemotherapy ,business.industry ,Cytarabine ,Hematopoietic Stem Cell Transplantation ,High-Throughput Nucleotide Sequencing ,Hematology ,Middle Aged ,Allografts ,Prognosis ,Combined Modality Therapy ,Progression-Free Survival ,MRD Negative ,Neoplasm Proteins ,Leukemia, Myeloid, Acute ,030220 oncology & carcinogenesis ,CCAAT-Enhancer-Binding Proteins ,Female ,Myeloid leukaemia ,Idarubicin ,business ,030215 immunology - Abstract
Acute myeloid leukaemia (AML) patients with biallelic mutations of CEBPA (bi CEBPA) have a 30-50% relapse rate. This study established the value of mutations based on next-generation sequencing (NGS) and multiparameter flow cytometric measurable residual disease (MFC-MRD) detection and compared the outcomes. From 2014 to 2018, 124 newly diagnosed bi CEBPA AML patients were treated. The median age was 37·5 (16-69) years. The 3-year cumulative incidence of relapse (CIR), relapse-free survival (RFS) and overall survival (OS) were 33·0%, 64·7% and 84·3%, respectively. Patients without additional mutations and with GATA2 mutations were defined as 'NGS low risk', which was the only favourable independent factor for CIR and RFS of pretreatment parameters. Patients with sustained positive MRD after two consolidation cycles and MRD negative losses at any time were defined as 'MRD high risk', which was the only poor independent factor for CIR, RFS and OS, including pretreatment and post-treatment parameters. In CR2 and non-remission patients who underwent allo-HSCT, superior OS was achieved. We conclude that NGS low risk was a favourable factor in the analysis of pretreatment parameters. MRD risk stratification was an independent prognostic factor in pretreatment and post-treatment parameters. Relapsed patients still have a favourable outcome followed by allo-HSCT.
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- 2020
27. Improving the prediction of acute myeloid leukaemia outcomes by complementing mutational profiling withex vivochemosensitivity
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Joaquin Martinez-Lopez, Rosa Ayala, Julian Gorrochategui, Jaime Pérez-Oteyza, Inmaculada Rapado, Joan Ballesteros, Eva Barragán, Pau Montesinos, José Luis Rojas, David Martínez-Cuadrón, Esther Onecha, María Linares, Elena Magro, Blanca Boluda, Pilar Martínez-Sánchez, Claudia Sargas, Yanira Ruiz-Heredia, Jesús Villoria, and Pilar Herrera
- Subjects
Adult ,Male ,Oncology ,Drug ,medicine.medical_specialty ,Adolescent ,media_common.quotation_subject ,Drug resistance ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Aged ,media_common ,Aged, 80 and over ,biology ,business.industry ,Hazard ratio ,EZH2 ,Hematology ,Middle Aged ,Leukemia, Myeloid, Acute ,Treatment Outcome ,KMT2A ,030220 oncology & carcinogenesis ,Mutation ,Cohort ,biology.protein ,Female ,Myeloid leukaemia ,business ,Ex vivo ,030215 immunology - Abstract
Refractoriness to induction therapy and relapse after complete remission are the leading causes of death in patients with acute myeloid leukaemia (AML). This study focussed on the prediction of response to standard induction therapy and outcome of patients with AML using a combined strategy of mutational profiling by next-generation sequencing (NGS, n = 190) and ex vivo PharmaFlow testing (n = 74) for the 10 most widely used drugs for AML induction therapy, in a cohort of adult patients uniformly treated according to Spanish PETHEMA guidelines. We identified an adverse mutational profile (EZH2, KMT2A, U2AF1 and/or TP53 mutations) that carries a greater risk of death [hazard ratio (HR): 3·29, P < 0·0001]. A high correlation was found between the ex vivo PharmaFlow results and clinical induction response (69%). Clinical correlation analysis showed that the pattern of multiresistance revealed by ex vivo PharmaFlow identified patients with a high risk of death (HR: 2·58). Patients with mutation status also ran a high risk (HR 4·19), and the risk was increased further in patients with both adverse profiles (HR 4·82). We have developed a new score based on NGS and ex vivo drug testing for AML patients that improves upon current prognostic risk stratification and allows clinicians to tailor treatments to minimise drug resistance.
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- 2020
28. Pharmacogenomics and regulation of apoptosis in acute myeloid leukaemia
- Author
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Nada Suvajdžić-Vuković and Zlatko Pravdić
- Subjects
0301 basic medicine ,Oncology ,medicine.medical_specialty ,Computer Networks and Communications ,medicine.medical_treatment ,ara-c ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Genetic variability ,pharmacogenomics ,anthracyclines ,Chemotherapy ,business.industry ,apoptosis ,030104 developmental biology ,aml ,Hardware and Architecture ,Apoptosis ,030220 oncology & carcinogenesis ,Pharmacogenomics ,Toxicity ,Cytarabine ,Medicine ,Myeloid leukaemia ,Stem cell ,business ,Software ,medicine.drug - Abstract
Acute myeloid leukaemia (AML) is a heterogenous clonal hematopoietic malignancy primarily treated with combination of cytarabine (ara-C) and anthracyclines. Despite high remission rates, especially in younger patients, a vast majority of patients die due to relapse or chemotherapy/stem cell transplantation-related toxicity. The partial explanation for this grim clinical outcome lies in the patients' genetic variability. In this review, we will summarize how genetic polymorphisms of proteins, in metabolic paths of cytarabine and anthracyclines and proteins involved in regulation of apoptosis, influence efficacy and toxicity in the AML treatment.
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- 2020
29. The face of remission induction
- Author
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Elias Jabbour, Caitlin R. Rausch, and Shilpa Paul
- Subjects
Oncology ,medicine.medical_specialty ,Standard of care ,business.industry ,Remission Induction ,High-Throughput Nucleotide Sequencing ,Hematology ,Disease ,Disease pathogenesis ,Minimal residual disease ,Disease-Free Survival ,Leukemia, Myeloid, Acute ,03 medical and health sciences ,Remission induction ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Internal medicine ,Remission Induction Therapy ,medicine ,Humans ,Effective treatment ,Precision Medicine ,Myeloid leukaemia ,business ,030215 immunology - Abstract
Acute myeloid leukaemia (AML) is a heterogeneous disease in which prognosis is determined by cytogenetic and molecular aberrations as well as patient-related factors, including age, prior haematologic disorders, and comorbidities. Despite the diverse disease biology, the standard of care for remission induction therapy has changed very little since its inception in 1973. Next generation sequencing has helped to increase our knowledge of the disease pathogenesis, allowing us to develop targeted and possibly more effective treatment options. Seven new agents have been approved for the treatment of AML since 2017, all of which are directed toward a specific molecular subtype or patient population. With the advent of these therapies, a more optimal, patient-specific approach rather than the historical 'one-size fits all' model can be utilised. This review will discuss the role of these novel therapies in the remission induction setting.
- Published
- 2019
30. Twenty five years of UK trials in acute myeloid leukaemia: what have we learned?
- Author
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Robert Kerrin Hills, Alan K. Burnett, and Nigel H. Russell
- Subjects
Male ,Oncology ,Clinical Trials as Topic ,medicine.medical_specialty ,Myeloid ,business.industry ,Hematology ,History, 20th Century ,medicine.disease ,History, 21st Century ,United Kingdom ,Leukemia, Myeloid, Acute ,Leukemia ,medicine.anatomical_structure ,Internal medicine ,medicine ,Humans ,Female ,Acute promyelocytic leukaemia ,Myeloid leukaemia ,business ,Aged - Published
- 2019
31. The role of allogeneic stem cell transplantation in the management of acute myeloid leukaemia: a triumph of hope and experience
- Author
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Charles Craddock, Ram Malladi, Justin Loke, and Paul Moss
- Subjects
Oncology ,Adult ,medicine.medical_specialty ,Neoplasm, Residual ,graft‐versus‐host disease ,medicine.medical_treatment ,Reviews ,Disease ,Review ,Conditioning regimen ,03 medical and health sciences ,0302 clinical medicine ,allogeneic stem cell transplantation ,Internal medicine ,hemic and lymphatic diseases ,Medicine ,Humans ,acute myeloid leukaemia ,business.industry ,Hematology ,Transplant failure ,Immunotherapy ,graft‐versus‐leukaemia ,medicine.disease ,Allografts ,Transplantation ,Leukemia, Myeloid, Acute ,Graft-versus-host disease ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Myeloid leukaemia ,Stem cell ,business ,030215 immunology ,Stem Cell Transplantation - Abstract
Summary Acute myeloid leukaemia (AML) is the commonest indication for allogeneic stem cell transplantation (allo‐SCT) worldwide. The accumulated experience of allografting in AML over the last four decades has provided critical insights into both the contribution of the conditioning regimen and the graft‐versus‐leukaemia effect to the curative potential of the most common form of immunotherapy utilised in standard clinical practice. Coupled with advances in donor availability and transplant technologies, this has resulted in allo‐SCT becoming an important treatment modality for the majority of adults with high‐risk AML. At the same time, advances in genomic classification, coupled with progress in the accurate quantification of measurable residual disease, have increased the precision with which allo‐mandatory patients can be identified, whilst simultaneously permitting accurate identification of those patients who can be spared the toxicity of an allograft. Despite this progress, disease recurrence still remains a major cause of transplant failure and AML has served as a paradigm for the development of strategies to reduce the risk of relapse ‒ notably the novel concept of post‐transplant maintenance, utilising pharmacological or cellular therapies.
- Published
- 2019
32. Patients aged less than 3 years with acute myeloid leukaemia characterize a molecularly and clinically distinct subgroup
- Author
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Akitoshi Kinoshita, Akio Tawa, Hirokazu Arakawa, Kentaro Ohki, Akiko Saito, Manabu Sotomatsu, Daisuke Tomizawa, Nobutaka Kiyokawa, Souichi Adachi, Tomohiko Taki, Keizo Horibe, Takashi Taga, Ken Tabuchi, Yasuhide Hayashi, Yusuke Hara, Genki Yamato, and Norio Shiba
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Disease-Free Survival ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Overall survival ,Humans ,In patient ,Cumulative incidence ,Child ,Retrospective Studies ,Gene Rearrangement ,Chemotherapy ,business.industry ,Age Factors ,Infant ,Hematology ,Neoplasm Proteins ,Survival Rate ,Leukemia, Myeloid, Acute ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,Myeloid leukaemia ,business ,030215 immunology - Abstract
Although infants (age
- Published
- 2019
33. Gemtuzumab ozogamicin in ( KMT2A )‐rearranged adult acute myeloid leukaemia (AML) in the UK Medical Research Council AML15 and AML16 trials
- Author
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Nigel H. Russell, Richard Dillon, Robert Kerrin Hills, and Alan Kenneth Burnett
- Subjects
Oncology ,medicine.medical_specialty ,biology ,Gemtuzumab ozogamicin ,business.industry ,Hematology ,Medical research ,KMT2A ,Internal medicine ,biology.protein ,medicine ,Myeloid leukaemia ,business ,medicine.drug - Published
- 2021
34. Establishment of a prognostic ferroptosis-related gene profile in acute myeloid leukaemia
- Author
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Ruonan Shao, Yue Lu, Shujing Lu, Huizhong Wang, Jingzi Wang, Wenjian Liu, and Hailin Tang
- Subjects
Oncology ,medicine.medical_specialty ,Disease ,Kaplan-Meier Estimate ,Internal medicine ,Gene profile ,Biomarkers, Tumor ,Medicine ,Humans ,prognostic model ,acute myeloid leukaemia ,Related gene ,Gene ,Receiver operating characteristic ,business.industry ,Ferroptosis ,Gene Expression Profiling ,Cell Biology ,Original Articles ,Prognosis ,ferroptosis ,gene profile ,Gene Expression Regulation, Neoplastic ,Leukemia, Myeloid, Acute ,ROC Curve ,Prognostic model ,Molecular Medicine ,Original Article ,Myeloid leukaemia ,business - Abstract
Acute myeloid leukaemia (AML) is a heterogeneous disease with a difficult to predict prognosis. Ferroptosis, an iron‐induced programmed cell death, is a promising target for cancer therapy. Nevertheless, not much is known about the relationship between ferroptosis‐related genes and AML prognosis. Herein, we retrieved RNA profile and corresponding clinical data of AML patients from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Univariate Cox analysis was employed to identify ferroptosis‐related genes significantly associated with AML prognosis. Next, the least absolute shrinkage and selection operator (LASSO) regression was employed to establish a prognostic ferroptosis‐related gene profile. 12 ferroptosis‐related genes were screened to generate a prognostic model, which stratified patients into a low‐ (LR) or high‐risk (HR) group. Using Kaplan‐Meier analysis, we demonstrated that the LR patients exhibited better prognosis than HR patients. Moreover, receiver operating characteristic (ROC) curve analysis confirmed that the prognostic model showed good predictability. Functional enrichment analysis indicated that the infiltration of regulatory T cells (Treg) differed vastly between the LR and HR groups. Our prognostic model can offer guidance into the accurate prediction of AML prognosis and selection of personalized therapy in clinical practice.
- Published
- 2021
35. Omacetaxine added to a standard acute myeloid leukaemia chemotherapy regimen reduces cellular FLIP levels, markedly increasing the incidence of eccrine hidradenitis
- Author
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Marylee Braniecki, Maria M. Tsoukas, John G. Quigley, Jonwei Hwang, Betul Gok Yavuz, and Naina Singh
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Incidence (epidemiology) ,Hematology ,medicine.disease ,Rash ,Chemotherapy regimen ,Hidradenitis ,Leukemia ,Flip ,Internal medicine ,medicine ,medicine.symptom ,Myeloid leukaemia ,business - Published
- 2021
36. Multiplex Screening for Interacting Compounds in Paediatric Acute Myeloid Leukaemia
- Author
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Lauren Cairns, Katrina M. Lappin, Alexander Mutch, Kyle B. Matchett, Ken I. Mills, and Ahlam A. Ali
- Subjects
Oncology ,medicine.medical_specialty ,multiplex screening ,Myeloid ,paediatric ,medicine.drug_class ,QH301-705.5 ,Cell Survival ,Blotting, Western ,Antineoplastic Agents ,Disease ,Catalysis ,Article ,Vinca alkaloid ,Cell Line ,Inorganic Chemistry ,Internal medicine ,hemic and lymphatic diseases ,Cell Line, Tumor ,medicine ,Humans ,Multiplex ,acute myeloid leukaemia ,Physical and Theoretical Chemistry ,Biology (General) ,Molecular Biology ,QD1-999 ,neoplasms ,Spectroscopy ,Repurposing ,drug repurposing ,business.industry ,Organic Chemistry ,Drug Repositioning ,General Medicine ,Flow Cytometry ,Computer Science Applications ,Drug repositioning ,Chemistry ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,Mutation ,Vinblastine Sulfate ,Myeloid leukaemia ,business - Abstract
Paediatric acute myeloid leukaemia (AML) is a heterogeneous disease characterised by the malignant transformation of myeloid precursor cells with impaired differentiation. Standard therapy for paediatric AML has remained largely unchanged for over four decades and, combined with inadequate understanding of the biology of paediatric AML, has limited the progress of targeted therapies in this cohort. In recent years, the search for novel targets for the treatment of paediatric AML has accelerated in parallel with advanced genomic technologies which explore the mutational and transcriptional landscape of this disease. Exploiting the large combinatorial space of existing drugs provides an untapped resource for the identification of potential combination therapies for the treatment of paediatric AML. We have previously designed a multiplex screening strategy known as Multiplex Screening for Interacting Compounds in AML (MuSICAL), using an algorithm designed in-house, we screened all pairings of 384 FDA-approved compounds in less than 4000 wells by pooling drugs into 10 compounds per well. This approach maximised the probability of identifying new compound combinations with therapeutic potential while minimising cost, replication and redundancy. This screening strategy identified the triple combination of glimepiride, a sulfonylurea, pancuronium dibromide, a neuromuscular blocking agent, and vinblastine sulfate, a vinca alkaloid, as a potential therapy for paediatric AML. We envision that this approach can be used for a variety of disease-relevant screens allowing the efficient repurposing of drugs that can be rapidly moved into the clinic.
- Published
- 2021
37. Azacitidine and venetoclax for post‐transplant relapse in a case of CBFA2T3/GLIS2 childhood acute myeloid leukaemia
- Author
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Avijeet Kumar Mishra, Khushnuma Mullanfiroze, Robert Chiesa, and Ajay Vora
- Subjects
Oncology ,medicine.medical_specialty ,Venetoclax ,business.industry ,Azacitidine ,MEDLINE ,Hematology ,Post transplant ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Myeloid leukaemia ,business ,medicine.drug - Published
- 2021
38. Molecular characterisation of NPM1 and FLT3-ITD mutations in a central South African adult de novo acute myeloid leukaemia cohort
- Author
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Jean F. Kloppers, André de Kock, Johané Cronjé, and Anne-Cecilia van Marle
- Subjects
south africa ,Oncology ,NPM1 ,medicine.medical_specialty ,Clinical Biochemistry ,Chromosomal translocation ,symbols.namesake ,hemic and lymphatic diseases ,Internal medicine ,Multiplex polymerase chain reaction ,Medicine ,acute myeloid leukaemia ,Allele ,neoplasms ,Sanger sequencing ,business.industry ,Public Health, Environmental and Occupational Health ,npm1 ,body regions ,Medical Laboratory Technology ,aml ,frequency ,Cohort ,symbols ,flt3-itd ,Public aspects of medicine ,RA1-1270 ,Myeloid leukaemia ,business ,psychological phenomena and processes ,Flt3 itd - Abstract
Background Recognition of molecular abnormalities in acute myeloid leukaemia (AML) has improved our understanding of its biology. NPM1 and FLT3-ITD mutations are recurrent in AML and clinically significant. NPM1 mutations are associated with a favourable prognosis, while FLT3-ITD mutations are an independent poor prognostic factor in AML. Objective This study described the prevalence and molecular characteristics of the NPM1 and FLT3-ITD mutations in a newly diagnosed AML patient cohort in central South Africa. Methods The study included 40 de novo AML patients. An NPM1 and FLT3-ITD multiplex polymerase chain reaction assay was optimised to screen patients for the respective mutations and were confirmed using Sanger sequencing. The prevalence of the NPM1 and FLT3-ITD mutations were determined, and mutation-specific characteristics were described in relation to patients' demographic information and AML classifications. Results The patients' median age was 38.5 years, with 77.5% (n = 31) of patients being self-proclaimed Black Africans. AML with recurrent genetic abnormalities was most prevalent (57.5%; n = 23), of which acute promyelocytic leukaemia (APL) was most common (40.0%; n = 16). None of the patients had the NPM1 mutation. FLT3-ITD was present in 37.5% (6/16) of APL patients and in one (20.0%) of five AML patients with a t(8;21) translocation. Most patients had an FLT3-ITD allele ratio of ≥ 50% and ITD lengths of > 39 bp. Conclusion FLT3-ITD mutations were mainly found in APL cases at a similar prevalence as reported in the literature. High FLT3-ITD allele ratios and long ITD lengths predominated. No NPM1 mutations were detected.
- Published
- 2021
39. Combination romidepsin and azacitidine therapy is well tolerated and clinically active in adults with high-risk acute myeloid leukaemia ineligible for intensive chemotherapy
- Author
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Justin Loke, Marlen Metzner, Eleni Tholouli, Andy Peniket, Charles Craddock, Louise Hopkins, Aimee Jackson, Rebecca H. Boucher, Rebecca Bishop, Mark Drummond, Jiri Pavlu, Sonia Fox, and Paresh Vyas
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.drug_class ,Azacitidine ,Clinical Decision-Making ,Intensive chemotherapy ,Romidepsin ,Young Adult ,Refractory ,hemic and lymphatic diseases ,Internal medicine ,Depsipeptides ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Molecular Targeted Therapy ,neoplasms ,business.industry ,Histone deacetylase inhibitor ,Disease Management ,Hematology ,Prognosis ,Clinical trial ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Hypomethylating agent ,Cytogenetic Analysis ,Female ,Disease Susceptibility ,Myeloid leukaemia ,business ,medicine.drug - Abstract
Azacitidine (AZA) is important in the management of patients with acute myeloid leukaemia (AML) who are ineligible for intensive chemotherapy. Romidepsin (ROM) is a histone deacetylase inhibitor which synergises with AZA in vitro. The ROMAZA trial established the maximum tolerated dose (MTD) of combined ROM/AZA therapy in patients with AML, as ROM 12 mg/m2 on Days 8 and 15, with AZA 75 mg/m2 administered for 7/28 day cycle. Nine of the 38 (23·7%) patients treated at the MTD were classified as responders by Cycle 6 (best response: complete remission [CR]/incomplete CR n = 7, partial response n = 2). Correlative next-generation sequencing studies demonstrated important insights into therapy resistance.
- Published
- 2021
40. Less Intensive 1 (LI1) Trial: A Randomized Phase II/III Clinical Trial in Approximately 1000 Elderly Patients With Acute Myeloid Leukaemia (AML) Deemed Not Suitable for Intensive Chemotherapy
- Author
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R Hills, Cono Ariti, Michael Dennis, N Russell, Ian Thomas, Alan K. Burnett, Laura Upton, and Mhairi Copland
- Subjects
Clinical trial ,Oncology ,medicine.medical_specialty ,Text mining ,business.industry ,Internal medicine ,Medicine ,Intensive chemotherapy ,Myeloid leukaemia ,business - Abstract
BackgroundAcute myeloid leukaemia (AML) is a heterogeneous disease where outcome is substantially influenced by age. Over the last 30-40 years, significant improvements have been made in survival for younger patients (those under 60). However, with the median age of the disease at diagnosis at 65 years, outcome in older patients has improved much less. Additionally, many elderly patients are not considered suitable for intensive chemotherapy and the current standard treatment is considered unsatisfactory. MethodsLI1 will evaluate several relevant therapeutic questions in AML patients over 60 years of age for whom intensive chemotherapy is not considered suitable. Patients are invited to enter a randomized comparison of standard therapy (LD Ara-C) versus a novel treatment. A number of different treatment options are available at any one time, but there is no comparison between novel agents. If, at initial review, a novel agent is deemed unlikely to demonstrate the required improvement, it may be removed from the protocol and replaced with another novel agent, via protocol amendment. Agents are initially entered into a phase II comparison against standard of care - where an agent is considered promising at interim review (based on remission rates), the randomisation may be extended to a fully powered phase III comparison based on survival. Agents which may prolong survival or improve remission rates will also be required to demonstrate equivalence or better of quality of life in patients – therefore, quality of life assessments are undertaken throughout, in each arm. DiscussionEven when less intensive treatment options are delivered, the outcomes are not satisfactory. The NCRI AML working group has a strong network, required for delivery of this trial program. The UK network is augmented by international collaborative groups, most notably from New Zealand and Denmark. The use of the Pick-a-Winner design improves efficiency and speed of review of the available novel agents with the aim of benefitting the increasing number of patients in this age group.Trial registration: ISCRTN40571019, EUDRACT2011-000479-19 (12th May 2011)
- Published
- 2021
41. High expression of TARP correlates with inferior FLT3 mutations in non-adolescents and young adults with acute myeloid leukaemia
- Author
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Yuye Shi, Banghe Ding, Liang Yu, Liye Bei, Chunling Wang, Shan-Dong Tao, Hong Tao, and Zhengmei He
- Subjects
Oncology ,Adult ,Male ,Prognostic factor ,medicine.medical_specialty ,endocrine system diseases ,Adolescent ,Bone Marrow Cells ,Malignancy ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Young adult ,neoplasms ,business.industry ,Hematology ,medicine.disease ,Gene Expression Regulation, Neoplastic ,Haematopoiesis ,Leukemia, Myeloid, Acute ,fms-Like Tyrosine Kinase 3 ,030220 oncology & carcinogenesis ,Flt3 mutation ,Risk stratification ,Mutation ,Female ,Myeloid leukaemia ,business ,Databases, Nucleic Acid ,030215 immunology - Abstract
Acute myeloid leukaemia (AML) is a haematopoietic malignancy with a dismal outcome. Consequently, risk stratification based on more effective prognostic biomarkers is crucial to make accurate therapy decisions. T cell receptor gamma alternative reading frame protein (TARP) has been reported in prostate and breast cancers, but its correlation with AML remains unclear.Differential expression of TARP mRNA in different AML subtypes was analysed using the UALCAN online platform. Its relationship with baseline clinical attributes, survival and efficacy were analysed based on three GSE1159, GSE425 and GSE6891 microarray datasets downloaded from Gene Expression Omnibus (GEO) and Oncomine databases. Quantitative real-time PCR was performed to determine mRNA levels of TARP in bone marrow mononuclear cells (BMMCs) isolated from AML patients.TARP was significantly overexpressed in AML patients. In AML, relatively low TARP expression was associated with theOur findings suggest that TARP might be a potential prognostic marker of AML and serve as a promising immunotherapeutic target.
- Published
- 2021
42. CPX-351: an attractive option for the treatment of older patients with high-risk or secondary acute myeloid leukaemia
- Author
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Adriana Plesa and Xavier Thomas
- Subjects
Oncology ,medicine.medical_specialty ,Myeloid ,Daunorubicin ,business.industry ,MEDLINE ,Cytarabine ,Neoplasms, Second Primary ,Hematology ,medicine.disease ,Leukemia ,Leukemia, Myeloid, Acute ,medicine.anatomical_structure ,Text mining ,Older patients ,Internal medicine ,medicine ,Humans ,Myeloid leukaemia ,business ,medicine.drug - Published
- 2021
43. Temporal changes in survival among adult patients with acute myeloid leukaemia in the period 2000–2016:a Danish population-based study
- Author
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Tarec Christoffer El-Galaly, Kim Theilgaard-Mönch, Claus Werenberg Marcher, Marianne Tang Severinsen, Peter Møller, Therese Maria Henriette Naur, Lasse Hjort Jakobsen, Martin Bøgsted, Hans Beier Ommen, Anne Stidsholt Roug, Daniel Kristensen, Claudia Schöllkopf, and Andreas Kiesbye Øvlisen
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Danish population ,Denmark ,Period (gene) ,Population ,temporal survival ,Disease-Free Survival ,Danish ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Overall survival ,Humans ,In patient ,acute myeloid leukaemia ,Registries ,education ,Aged ,Retrospective Studies ,Aged, 80 and over ,education.field_of_study ,Adult patients ,business.industry ,Age Factors ,Hematology ,Middle Aged ,language.human_language ,real-world patients ,Survival Rate ,Leukemia, Myeloid, Acute ,030220 oncology & carcinogenesis ,language ,Female ,Myeloid leukaemia ,business ,030215 immunology - Abstract
In the present study, we quantify the progress in overall survival (OS) during the period 2000-2016 among Danish patients with acute myeloid leukaemia (AML). This population-based study, including 3820 adult patients with AML, demonstrates a significantly improved OS over time with the 2-year age-standardised OS increasing from 22% in 2002 to 31% in 2016. The improvement in OS was exclusively seen in patients with AML aged ≥50 years, with absolute improvements in 2-year OS from 2002 to 2016 of ≥10% among patients aged 50-75 years and a small absolute increase in those aged >75 years.
- Published
- 2021
44. Real-world data confirming the efficacy and safety of decitabine in acute myeloid leukaemia – results from a retrospective Belgian registry study
- Author
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Joris Diels, Marieke Van Kouwenhove, Daan Dierickx, Sandra Van Hoorenbeeck, Margaret Doyle, Bart Malfait, Benjamin Bailly, Karin Caekelbergh, Janice Geers, Joost Braakman, Isabelle Vande Broek, Stef Meers, and Pierre Chevalier
- Subjects
Antimetabolites, Antineoplastic ,medicine.medical_specialty ,TRANSFUSION INDEPENDENCE ,Registry study ,MULTICENTER ,Decitabine ,Secondary AML ,03 medical and health sciences ,Medicine, General & Internal ,0302 clinical medicine ,Belgium ,General & Internal Medicine ,Internal medicine ,medicine ,Humans ,acute myeloid leukaemia ,Transfusion independence ,Registries ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Science & Technology ,real-world data ,OLDER PATIENTS ,business.industry ,Standard treatment ,Induction chemotherapy ,ADULTS ,General Medicine ,Leukemia, Myeloid, Acute ,LOW-DOSE CYTARABINE ,Treatment Outcome ,030220 oncology & carcinogenesis ,Azacitidine ,SURVIVAL ,Myeloid leukaemia ,business ,Life Sciences & Biomedicine ,Real world data ,medicine.drug - Abstract
Objectives: Currently, there is no standard treatment for patients with acute myeloid leukaemia (AML) ineligible for standard induction chemotherapy (IC). This study aimed to report real-world evidence data on the efficacy and safety of decitabine in this patient group.Methods: This study was a Belgian, retrospective, non-interventional, multicentre registry of patients ≥ 65 years, with newly-diagnosed de novo or secondary AML ineligible for IC. Patients were treated according to routine clinical practice. Overall survival (OS), progression-free survival (PFS) and transfusion independence for ≥8 consecutive weeks were evaluated.Results: Forty-five patients were enrolled, including 67% (n = 30) with secondary AML. Median OS and PFS were 7.3 months (95% CI: 2.2-11.1) and 4.1 months (95% CI: 2.1-7.6) respectively. A subpopulation analysis showed that patients treated with ≥4 cycles (n = 21) had significantly better outcomes compared to patients receiving
- Published
- 2019
45. Complete remission with incomplete count recovery (CRi) prior to allogeneic HCT for acute myeloid leukaemia is associated with a high non-relapse mortality
- Author
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Eduardo Olavarria, Divya Bansal, Renuka Palanicawandar, Eva Yebra-Fernandez, Jane F. Apperley, Jiří Pavlů, Philippa Woolley, Richard Szydlo, Andrew J. Innes, Fiona Fernando, Sara Lozano, Dragana Milojkovic, Philippa C. May, Elisabet Nadal-Melsio, and NIHR
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Myeloid ,business.industry ,Immunology ,Complete remission ,1103 Clinical Sciences ,Retrospective cohort study ,Allogeneic hct ,Hematology ,medicine.disease ,Leukemia ,medicine.anatomical_structure ,Internal medicine ,Medicine ,1112 Oncology and Carcinogenesis ,Nonrelapse mortality ,Young adult ,Myeloid leukaemia ,business - Published
- 2019
46. Myelodysplastic Syndrome (MDS) in a Child who Transformed to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC)
- Author
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Sianny Herawati, I Nyoman Wande, and Ni Komang Ayu Parmawati
- Subjects
Oncology ,medicine.medical_specialty ,lcsh:R5-920 ,business.industry ,lcsh:R ,lcsh:Medicine ,General Medicine ,acute myeloid leukemia with myelodysplasia-related changes, cytopenia, dysplasia, myelodysplastic syndromes ,Internal medicine ,hemic and lymphatic diseases ,medicine ,Myeloid leukaemia ,business ,lcsh:Medicine (General) - Abstract
Background: Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell diseases, accounting for < 5% of all hematologic malignancies in children.  MDS is characterized by cytopenia, dysplasia in one or more of the major myeloid lineages, ineffective hematopoiesis, and recurrent genetic abnormalities. Approximately 30% of patients with MDS show progression to AML within a few months up to several years. This is an MDS case report in children who have undergone Acute Myeloid Leukaemia transformation with Myelodysplasia-Related Changes (AML-MRC).Case Report: A 16-year-old boy came to the Emergency Department of Sanglah General Hospital with a complaint of pain and swelling in both knees and joints since last month. Fatigue and fever happened a week before admission. Previously, he had been hospitalized twice with the same symptoms. Physical examination revealed pale conjunctiva with pancytopenia in the laboratory result. A blood smear showed normochromic normocytic anemia, neutropenia, and thrombocytopenia. Bone marrow aspiration morphology showed hypercellularity with blast presentation > 10% and multilineage dysplasia > 50% supporting MDS diagnosed transformation to Acute Myeloid Leukaemia with Myelodysplasia-Related Changes (AML-MRC). Leukemia phenotyping showed positive results on CD 33, CD 36 and HLA-DR presenting Monocytic Lineage.                                                                                                            Conclusion: High degree dysplasia and blast percentage in blood and bone marrow increase tendency to transform into acute myeloid leukemia (AML). The diagnose of MDS requires analysis of blood and bone marrow morphology and cytogenetic analysis as a recommendation by WHO classification.
- Published
- 2019
47. Myeloblasts in normal bone marrows expressing leukaemia-associated immunophenotypes
- Author
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George Chan, Anna Ruskova, Anna Elinder Camburn, and Michelle Petrasich
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Neoplasm, Residual ,Adolescent ,CD34 ,CD15 ,Immunophenotyping ,Pathology and Forensic Medicine ,Flow cytometry ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Bone Marrow ,hemic and lymphatic diseases ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Granulocyte Precursor Cells ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Limiting ,Middle Aged ,Leukemia, Myeloid, Acute ,Haematopoiesis ,030104 developmental biology ,Normal bone ,030220 oncology & carcinogenesis ,Female ,Myeloid leukaemia ,business - Abstract
Measurable residual disease (MRD) status of patients undergoing treatment for acute myeloid leukaemia (AML) is important for prognosis and guides treatment. Multicolour flow cytometry (MCF) is a sensitive MRD method. The current approach relies on identification of blasts expressing leukaemia-associated immunophenotypes (LAIP) or by blasts expressing aberrant differentiation/maturation profiles compared to that seen in normal haematopoietic precursor cells at follow-up, i.e., different from normal (DFN). However, expression of LAIP on normal myeloblasts affects the specificity of the result, and the understanding of what is normal is important. Limited published data are currently available. We report findings from 14 normal adult bone marrows. MCF was performed on the residual normal marrow specimens from 14 adults. Expression of CD15, CD11b, CD7, CD4, and CD56 on CD34+ myeloblasts was assessed. Analysis of samples was performed using 4-colour flow cytometry which was the methodology used when this work was done, and is still being used in many clinical flow laboratories worldwide. LAIP is defined by lineage infidelity or asynchronous expression of differentiation markers. The cases of normal myeloblasts with LAIP involving the markers used and above the cut-off levels for MRD detection (0.01%) varies between 43% and 100%, limiting the specificity of the results for MRD. Even if the threshold is raised to 0.1%, there will still be false positive cases using aberrant CD15 or CD7. Our work provided useful information for AML MRD determination in our laboratory. A collaborative database of LAIP on normal myeloblasts using standardised analysis should be useful to determine the optimal diagnostic cut-off for AML MRD using LAIP.
- Published
- 2019
48. Parental occupational exposure to low-frequency magnetic fields and risk of leukaemia in the offspring: findings from the Childhood Leukaemia International Consortium (CLIC)
- Author
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Alice Kang, John D Dockerty, Olli Lohi, Madar Talibov, Theodora Psaltopoulou, Eleni Petridou, Ann Olsson, Eve Roman, Javier Vila, Lucia Miligi, Catherine Metayer, Logan G. Spector, Elisabeth Cardis, Friederike Erdmann, Jacqueline Clavel, Anssi Auvinen, Corrado Magnani, Helen D. Bailey, Joachim Schüz, Atte Nikkilä, Lääketieteen ja terveysteknologian tiedekunta - Faculty of Medicine and Health Technology, Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences, and Tampere University
- Subjects
Male ,Oncology ,elf-mf ,medicine.medical_specialty ,Adolescent ,Childhood leukemia ,Kansanterveystiede, ympäristö ja työterveys - Public health care science, environmental and occupational health ,Offspring ,case-control study ,acute lymphoblastic leukemia ,acute myeloid leukemia ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,hemic and lymphatic diseases ,Occupational Exposure ,Internal medicine ,occupation ,medicine ,Humans ,Child ,Workplace ,030304 developmental biology ,0303 health sciences ,business.industry ,Public Health, Environmental and Occupational Health ,Case-control study ,Infant ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,medicine.disease ,Childhood leukaemia ,Leukemia, Myeloid, Acute ,Magnetic Fields ,Maternal Exposure ,Case-Control Studies ,Child, Preschool ,Prenatal Exposure Delayed Effects ,030220 oncology & carcinogenesis ,Paternal Exposure ,Female ,Occupational exposure ,Myeloid leukaemia ,business - Abstract
ObjectivesPreviously published studies on parental occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and risk of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring were inconsistent. We therefore evaluated this question within the Childhood Leukemia International Consortium.MethodsWe pooled 11 case–control studies including 9723 childhood leukaemia cases and 17 099 controls. Parental occupational ELF-MF exposure was estimated by linking jobs to an ELF-MF job-exposure matrix (JEM). Logistic regression models were used to estimate ORs and 95% CIs in pooled analyses and meta-analyses.ResultsORs from pooled analyses for paternal ELF-MF exposure >0.2 microtesla (µT) at conception were 1.04 (95% CI 0.95 to 1.13) for ALL and 1.06 (95% CI 0.87 to 1.29) for AML, compared with ≤0.2 µT. Corresponding ORs for maternal ELF-MF exposure during pregnancy were 1.00 (95% CI 0.89 to 1.12) for ALL and 0.85 (95% CI 0.61 to 1.16) for AML. No trends of increasing ORs with increasing exposure level were evident. Furthermore, no associations were observed in the meta-analyses.ConclusionsIn this large international dataset applying a comprehensive quantitative JEM, we did not find any associations between parental occupational ELF-MF exposure and childhood leukaemia.
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- 2019
49. Efficacy outcomes in the treatment of older or medically unfit patients with acute myeloid leukaemia: A systematic review and meta-analysis
- Author
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A. Stone, Tsila Zukerman, Liat Flaishon, Jacob M. Rowe, and Ruth Ben Yakar
- Subjects
Male ,Antimetabolites, Antineoplastic ,Cancer Research ,medicine.medical_specialty ,Azacitidine ,Decitabine ,Drug Administration Schedule ,03 medical and health sciences ,0302 clinical medicine ,Overall response rate ,Induction therapy ,Internal medicine ,medicine ,Humans ,Aged ,business.industry ,Remission Induction ,Age Factors ,Cytarabine ,Treatment options ,Hematology ,Middle Aged ,Survival Analysis ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Oncology ,030220 oncology & carcinogenesis ,Meta-analysis ,Female ,Myeloid leukaemia ,business ,030215 immunology ,medicine.drug - Abstract
Older and medically unfit patients with acute myeloid leukaemia (AML) who are unsuitable for standard induction therapy have limited treatment options. A meta-analysis was performed with two objectives: 1) to describe outcomes for patients treated with hypomethylating agents, either decitabine or azacitidine, or low-dose cytarabine (LDAC) and 2) to describe the effect of age (75 vs ≥75) on the remission rates. Thirteen published multi-centre studies in 1822 patients were identified where patients were treated with hypomethylating agents or LDAC. A random effects meta-analysis was performed to provide a pooled estimate of efficacy for the following endpoints: complete remission (CR), overall response rate (CR + complete remission with incomplete white blood cell recovery [CRi]), relapse free survival (RFS), overall survival (OS), and 60-day mortality. For all endpoints apart from RFS, there was significant unexplained between-trial variability (I
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- 2019
50. Clinicopathological and molecular characteristics of extramedullary acute myeloid leukaemia
- Author
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Deniz Peker, Constantine Kanakis, Jeffery A Jones, Danielle Fasciano, David Ullman, David Dorn, Zheng Ping, Donna Salzman, and Richard G. Koenig
- Subjects
Adult ,Male ,0301 basic medicine ,Oncology ,medicine.medical_specialty ,Poor prognosis ,Histology ,Myeloid ,Abnormal Karyotype ,Pathology and Forensic Medicine ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Myeloid sarcoma ,Humans ,Neoplasm ,In patient ,Sarcoma, Myeloid ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Medical record ,Karyotype ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Myeloid leukaemia ,business - Abstract
AIMS Myeloid sarcoma (MS) is a rare extramedullary neoplasm composed of immature myeloid precursor cells thought to be a unique clinical presentation of acute myeloid leukaemia (AML). Like AML, MS has a poor prognosis, but due to the rare nature of MS there are limited studies examining potential prognostic factors. We report our institutional experience, with the aim of investigating and establishing salient clinicopathological and molecular features of MS. METHODS AND RESULTS We retrospectively examined all clinicopathological and molecular data on MS patients between 2001 and 2017 from the University of Alabama at Birmingham (UAB) electronic medical records. The UAB electronic medical records were also reviewed and compared with the literature for other potential prognostic factors. Sixty-three patients were included in the study. The median overall survival was 24 months in the group with normal karyotype and 12 months in patients with an abnormal karyotype. CONCLUSIONS We found that an abnormal karyotype was associated with a statistically significant worse prognosis.
- Published
- 2019
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