Is it time to change conventional consolidation chemotherapy for acute myeloid leukemia in CR1?

Wolach, Ofir; Stone, Richard

doi:10.1097/moh.0000000000000119

Cited by 4 publications

(4 citation statements)

References 87 publications

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“…9,10 The 5-year OS was 43%, and for patients with a ckit mutation, the OS was 40%. 11,12 The present study showed that 58 patients with AML with CBFB-MYH11 had a CR rate of 98Á3% after one course of treatment and a CR rate of 100% after two cumulative courses of treatment, showing good efficacy.…”

Section: Discussionsupporting

confidence: 50%

The loss or absence of minimal residual disease of <0·1% at any time after two cycles of consolidation chemotherapy in CBFB–MYH11‐positive acute myeloid leukaemia indicates poor prognosis

et al. 2020

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No consensus has been reached on the relationship between CBFB-MYH11 copies and prognosis. Of 1525 acute myeloid leukemia (AML) patients, 58 with CBFB-MYH11-positive AML (16/58 patients with c-kit mutation) were retrospectively analyzed with a median follow-up duration of 29.8 (range: 4.8-74.4) months. Of these, 25/58 (43.1%) patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), 10 of whom had the c-kit mutation. Of the 33 patients who did not undergo allo-HSCT, recurrence in patients with CBFB-MYH11/ABL level >0.1% at any time after two consolidation cycles was significantly higher than in patients with CBFB-MYH11/ABL level <0.1% (61.9% vs. 0%, P = 0.001); further, the 3-year relapse-free survival (RFS; 31.4% vs. 100%, P = 0.004) and event-free survival (EFS; 33.1% vs. 100%, P = 0.004) were significantly decreased in patients with CBFB-MYH11/ABL level >0.1% at any time after two consolidation cycles. The 3-year RFS and EFS rates were lower in patients who did not receive allo-HSCT than in those who did (31.4% vs 84.6%, P = 0.000; 31.4% vs. 80.8%, P = 0.001). CBFB-MYH11-positive AML patients with CBFB-MYH11/ABL level >0.1% at any time after two cycles of consolidation had poor prognoses, and allo-HSCT could improve their survival.

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Section: Discussionsupporting

confidence: 50%

The loss or absence of minimal residual disease of <0·1% at any time after two cycles of consolidation chemotherapy in CBFB–MYH11‐positive acute myeloid leukaemia indicates poor prognosis

et al. 2020

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“…Although CBF-AML patients have better prognosis, only approximately 40–60% are cured by standard therapy using a backbone of high dose cytarabine treatment in combination with an anthracycline 53,54 which is essentially unchanged for the past 40 years 55 . A study of 285 newly diagnosed patients with AML showed that high dose cytarabine treatment provides the best outcome for CBF-AML patients with 50% demonstrating CR after 5 years 56 .…”

Section: Treatmentmentioning

confidence: 99%

“…A study with patients (up to 45 years) in complete remission (CR) showed that though there is no difference in disease free survival rate for patients with inv(16) and t(8;21), when allo-or auto-SCT were performed after intensive consolidation therapy, the OS was better for younger patients receiving allo-SCT 62 . HSCT is not necessary in first CR for patients with CBF leukemias unless they have relapsed, refractory or otherwise high risk disease 54,63 . However, patients older than 75 years have very poor prognosis and patients over 60 years may be considered for allo-HSCT 28 .…”

Section: Treatmentmentioning

confidence: 99%

Core Binding Factor Acute Myeloid Leukemia: New Prognostic Categories and Therapeutic Opportunities

Sinha

Cunningham

Liu

2015

Seminars in Hematology

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Core binding factor (CBF) is a heterodimeric protein complex involved in the transcriptional regulation of normal hematopoiesis. Mutations in CBF-encoding genes result in leukemogenic proliferative advantages and impaired differentiation of the hematopoietic progenitors. CBF molecular aberrations are responsible for approximately 20% of all adult acute myeloid leukemia (AML). Although CBF-AMLs are considered to have relatively good prognosis compared to other leukemia subtypes, they are a heterogeneous group of disorders and modern therapy frequently leads to relapse and the associated morbidity and mortality. Improvements in risk stratification and development of targeted therapies are needed for better outcomes. In this review we provide a brief overview of the molecular basis, prognostic categories and the advanced treatment strategies for CBF leukemias.

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“…However, at times, many obstacles to further progress present themselves, including limitations in funding for laboratory and clinical studies, as well as government and institutional regulatory impediments. Wolach and Stone [7] review potential changes in our approach to consolidation therapy. Nevertheless, the intellectual satisfaction of important advances in understanding human disease carries the day.…”

mentioning

confidence: 99%

The best of times in hematologic malignancies

Tallman

2015

Current Opinion in Hematology

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Is it time to change conventional consolidation chemotherapy for acute myeloid leukemia in CR1?

Cited by 4 publications

References 87 publications

The loss or absence of minimal residual disease of <0·1% at any time after two cycles of consolidation chemotherapy in CBFB–MYH11‐positive acute myeloid leukaemia indicates poor prognosis

The loss or absence of minimal residual disease of <0·1% at any time after two cycles of consolidation chemotherapy in CBFB–MYH11‐positive acute myeloid leukaemia indicates poor prognosis

Core Binding Factor Acute Myeloid Leukemia: New Prognostic Categories and Therapeutic Opportunities

The best of times in hematologic malignancies

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