Guidelines on the management of acute myeloid leukaemia in adults

Milligan, Donald; Grimwade, David; Cullis, Jonathan O.; Bond, Laura; Swirsky, D; Craddock, Charles; Kell, Jonathan; Homewood, J.; Campbell, Kevin J.; McGinley, Susan; Wheatley, Keith; Jackson, GH

doi:10.1111/j.1365-2141.2006.06314.x

Cited by 130 publications

(65 citation statements)

References 167 publications

(210 reference statements)

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“…[1][2][3] Patients who could proceed to an allogeneic transplantation, either after a sequential conditioning regimen in case of refractory disease 4 or after a standard or reduced intensity conditioning regimen in case of second complete remission (CR), 3,5 are likely to have the best chances to achieve long-term overall survival (OS).…”

Section: Introductionmentioning

confidence: 99%

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

et al. 2011

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A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19-70) receiving a combination of intensive chemotherapy þ Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36 ± 4%, respectively. Disease status (relapse o12 months, including refractory patients), FLT3-ITD-positive status and high-risk cytogenetics were the three strongest independent adverse prognostic factors for OS and EFS in this series. We then defined three subgroups with striking different outcomes at 2 years: no adverse factor (favourable, N ¼ 36): OS 58%, EFS 45%; one adverse factor (intermediate, N ¼ 54): OS 37%, EFS 31%; two or three adverse factors (poor, N ¼ 43): OS 12%, EFS 12% (Po10 À4 , P ¼ 0.001). This new simplified Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.

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Section: Introductionmentioning

confidence: 99%

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

et al. 2011

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“…IC is not appropriate for all patients with AML, and eligibility is influenced by age, performance status, comorbidities, and preexisting MDS [27][28][29]70]. There is an unmet need for effective treatment options for patients who are ineligible or unwilling to receive IC [29].…”

Section: Oral Azacitidine In Patients With Amlmentioning

confidence: 99%

“…Similar to MDS, AML incidence increases with advancing age, with incidence rates in the U.S. and Europe of 10 per 100,000 persons or higher for patients aged $65 years [14,15]. AML has a poor prognosis, particularly in older patients and those with adverse disease characteristics (e.g., secondary AML, complex cytogenetic abnormalities, or FLT3 mutation) [26][27][28][29][30]. Three-quarters of patients with AML die within 5 years of diagnosis, and survival decreases with increasing age [26].…”

Section: Introductionmentioning

confidence: 99%

“…Three-quarters of patients with AML die within 5 years of diagnosis, and survival decreases with increasing age [26]. Disease characteristics and performance status are closely considered when evaluating patient eligibility for treatment with intensive therapies (e.g., induction followed by consolidation chemotherapy or stem cell transplant [SCT]) versus low-intensity options such as injectable azacitidine or decitabine [27][28][29][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

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Oral Azacitidine (CC-486) for the Treatment of Myelodysplastic Syndromes and Acute Myeloid Leukemia

Cogle

Scott

Boyd³

2015

The Oncologist

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The myelodysplastic syndromes (MDS) comprise a heterogeneous group of clonal myeloid malignancies characterized by multilineage cytopenias, recurrent cytogenetic abnormalities, and risk of progression to acute myeloid leukemia (AML). AML, which can occur de novo as well as secondary to MDS, is characterized by malignant clones of myeloid lineage in the bone marrow and peripheral blood, with dissemination into tissues. The cytidine nucleoside analog and epigenetic modifier azacitidine is approved in the U.S. for the treatment of all French-American-British subtypes of MDS and in many countries for the treatment of AML with 20%-30% blasts and multilineage dysplasia according to the World Health Organization classification. Benefits of azacitidine treatment of patients with AML with .30% blasts have also been shown in a recent phase III trial. Oral administration of azacitidine may enhance patient convenience, eliminate injection-site reactions, allow for alternative dosing and scheduling, and enable long-term treatment. Phase I studies with oral azacitidine (CC-486) have shown biological activity, clinical responses, and tolerability in patients with MDS and AML. Extended dosing schedules of oral azacitidine (for 14 or 21 days of 28-day cycles) are currently under investigation as frontline therapy in patients with lower risk MDS, as maintenance therapy for patients with AML not eligible for stem cell transplant, and as maintenance therapy for patients with MDS or AML following stem cell transplant. This review presents clinical data supporting the use of injectable azacitidine in MDS and AML and examines the rationale for and results of the clinical development of oral azacitidine.

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“…Over the past three decades, the outcome of patients with acute myeloid leukemia (AML) has improved with the incorporation of intensive induction and post-remission treatment, including allogeneic and autologous hematopoietic stem cell transplantation (HCT), and improvements in supportive care (1)(2)(3). However, while randomized clinical trials have reported high long-term survival rates, the results of population-based studies have shown long-term remissions in a quarter of patients only (4)(5)(6)(7).…”

mentioning

confidence: 99%

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

Filho

Portugal

Loureiro

et al. 2011

Braz J Med Biol Res

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Guidelines on the management of acute myeloid leukaemia in adults

Cited by 130 publications

References 167 publications

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

Oral Azacitidine (CC-486) for the Treatment of Myelodysplastic Syndromes and Acute Myeloid Leukemia

Characterization and analysis of the outcome of adults with acute myeloid leukemia treated in a Brazilian University hospital over three decades

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