Escalation of daunorubicin and addition of etoposide in the ADE regimen in acute myeloid leukemia patients aged 60 years and older: Cancer and Leukemia Group B Study 9720

Baer,; George, SL; Sanford, B.; Mrózek, Krzysztof; Je, Kolitz; Je, Moore; Rm, Stone; Bl, Powell; Caligiuri, M. A.; Cd, Bloomfield; Larson, Richard A.

doi:10.1038/leu.2011.9

Cited by 24 publications

(20 citation statements)

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“…Other studies have reported response rates of 46% (6/13 patients) [27], 50% (3/6 patients) [36], and 62% (8/13 patients) [37]. The CR rates for patients with secondary AML in general (evolved from either MDS or MPD) are reported to be in the range of 30-60% [38][39][40][41]. The data reported here, combined with limited data from the literature, suggest that a significant percentage of patients with MPN-BP can achieve CR or CP after induction chemotherapy, and may thus be candidates for allo-SCT.…”

Section: Discussionmentioning

confidence: 92%

Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase

et al. 2012

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Section: Discussionmentioning

confidence: 92%

Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase

et al. 2012

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“…Although essentially all patients received anthracycline and cytarabine-based induction therapy, multiple postremission therapies were administered. [16][17][18][19][20][21][22][23] Additionally, supportive care for AML patients undergoing intensive therapy has improved in the last 2 decades.…”

Section: Discussionmentioning

confidence: 99%

“…21 CALGB 9420 (phase 1) and CALGB 9720 (phase 3) evaluated multidrug resistance modulation by PSC-833 during induction and consolidation therapy with cytarabine, daunorubicin, and etoposide, but the PSC-833 arm was closed after random assignment of 120 patients because of a high number of early deaths. 22,23 Enrollment continued for patients on the chemotherapy-only control arm. Postremission therapy consisted of a single cytarabine, daunorubicin, and etoposide consolidation course also with PSC-833 until arm closure and the patients were subsequently randomly assigned to receive or not rIL2 maintenance therapy similar to CALGB 19808.…”

Section: Cytogenetic Studiesmentioning

confidence: 99%

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Ten-year outcome of patients with acute myeloid leukemia not treated with allogeneic transplantation in first complete remission

et al. 2018

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Key Points• Only 16.6% of patients aged ,60 years and 2.4% aged $60 years treated with chemotherapy are disease-free at 10 years after diagnosis.• Ten-year disease-free survivors were mostly diagnosed with corebinding factor AML with t(8;21) or inv(16), or had a normal karyotype.The probability that adult patients with de novo acute myeloid leukemia (AML) receiving intensive chemotherapy in the absence of allogeneic hematopoietic stem cell transplantation (Allo-HCT) in first complete remission (CR1) will be disease-free at 10 years after diagnosis, of those aged $60 years were alive and disease-free. This disease-free AML group consisted predominantly of patients with core-binding factor AML with t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22) and those with a normal karyotype. Occurrences of AML beyond 10 years were infrequent and associated with cytogenetic findings different from those at diagnosis. These data provide evidence that the frequency of long-term cure of AML is low among younger and especially older patients in the absence of Allo-HCT in CR1.In older patients not appropriate for Allo-HCT, these data provide further justification for early use of alternative treatments outside of intensive chemotherapy.

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“…Intensive induction is effective in selected octogenarian acute myeloid leukemia patients: prognostic significance of karyotype and selected molecular markers used in the European LeukemiaNet classification 27 6 patients) and low-dose chemotherapy (CALGB 8923 and 9720, 27,29 BGMT 95 24 and ALFA 9803, 30 for a total of 9 patients]. Three patients on AMLCG 99 also received maintenance chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Intensive induction is effective in selected octogenarian acute myeloid leukemia patients: prognostic significance of karyotype and selected molecular markers used in the European LeukemiaNet classification

et al. 2013

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© F e r r a t a S t o r t i F o u n d a t i o nknown, 12-16 but few groups 6,7,17,18 have studied its effect in octogenarian AML patients and conclusions have been mixed. This may stem from the differences in classification systems among studies, treatments, inadequate numbers of patients or all of the above. We, therefore, evaluated whether the European LeukemiaNet (ELN) classification, 19 a modified ELN classification (i.e., a classification based only on karyotype, without molecular markers), and the ELN-associated molecular alterations FLT3-ITD and NPM1 mutations have prognostic significance in octogenarian AML patients receiving intensive induction treatment. Methods Patients, treatment, cytogenetic and molecular analysesWe analyzed octogenarian AML patients treated with intensive induction [cytarabine and anthracycline (7+3) or similar regimens] for whom pretreatment karyotyping information was available. The patients were drawn from the German-Austrian AML Study Group [AMLSG; 5 (0.5%) Pretreatment karyotype analyses were performed by the Cooperative Groups' institutional cytogenetic laboratories with the results confirmed by central karyotype review, or were performed centrally. The diagnosis of cytogenetically normal AML (CN-AML) was based on the analysis of ≥20 metaphase cells in bone marrow specimens subjected to short-term culture. 31 We used both a modified, karyotype only, ELN-based classification [including t(8;21) Statistical analysesEstimated probabilities of relapse-free survival and overall survival were calculated using the Kaplan-Meier method, and the logrank test evaluated differences between survival distributions. Associations for baseline demographic, clinical, and molecular features were compared using the Fisher exact and Wilcoxon rank sum tests for categorical and continuous variables, respectively. All analyses were two-sided, with a P-value <0.05 considered statistically significant.Response criteria are described in the Online Supplementary Material. ResultsThe 138 patients had a median age of 82 years (range, 80-89 years); 81 (59%) were male. One-hundred fifteen patients had de novo AML, 13 had secondary AML following an antecedent hematologic disorder (s-AML), nine had therapy-related AML (t-AML) and one had both s-AML and t-AML. Because there was no difference in complete response, relapse-free survival and overall survival rates between patients with de novo AML and s-AML/t-AML, all patients were considered together for outcome analyses. Thirteen (11%) patients had an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 71 (58%) had a PS of 1, 31 (25%) had a PS of 2, six (5%) had a PS of 3 and one (1%) patient had a PS of 4; information on PS was not available for 16 of the patients. Normal karyotype was the most common cytogenetic finding (47.1%), followed by complex karyotype (14.5%) and sole +8 (9.4%). We first categorized patients according to the modified ELN classification into favorable (n=2), intermediate-I (n=65), intermediate-II (n=42) ...

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Escalation of daunorubicin and addition of etoposide in the ADE regimen in acute myeloid leukemia patients aged 60 years and older: Cancer and Leukemia Group B Study 9720

Cited by 24 publications

References 40 publications

Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase

Allogeneic stem cell transplantation for myeloproliferative neoplasm in blast phase

Ten-year outcome of patients with acute myeloid leukemia not treated with allogeneic transplantation in first complete remission

Intensive induction is effective in selected octogenarian acute myeloid leukemia patients: prognostic significance of karyotype and selected molecular markers used in the European LeukemiaNet classification

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