Salvage treatment for refractory or relapsed acute myeloid leukemia: a 10-year single-center experience

OBJECTIVES: The outcomes of refractory and relapsed acute myeloid leukemia (AML) patients in developing countries are underreported, even though the similar classic regimens are widely used. METHODS: We conducted a retrospective comparison of “ MEC ” (mitoxantrone, etoposide, and cytarabine) and “ FLAG-IDA ” (fludarabine, cytarabine, idarubicin, and filgrastim) in adults with first relapse or refractory AML. RESULTS: In total, 60 patients were included, of which 28 patients received MEC and 32 received FLAG-IDA. A complete response (CR) rate of 48.3% was observed. Of the included patients, 16 (27%) died before undergoing bone marrow assessment. No statiscally significant difference in CR rate was found between the two protocols (p=0.447). The median survival in the total cohort was 4 months, with a 3-year overall survival (OS) rate of 9.7%. In a multivariable model including age, fms-like tyrosine kinase 3 (FLT3) status, and stem-cell transplantation (SCT), only the last two indicators remained significant: FLT3-ITD mutation (hazard ratio [HR]=4.6, p
Source: Clinics - Category: General Medicine Source Type: research

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Abstract Acute myelogenous leukemia (AML) is an aggressive hematological malignancy associated with high rates of mortality. This incidence is due to the complexity in which the AML cells interact with other healthy human cells. These phenomena create an environment that favors the expansion of leukemic cells, which will affect the patient's prognosis. An important aspect is the ability of AML cells to evade immune responses via targeting and signaling immune cells to suppress anti-tumor responses. Many studies have reported that associations among components in the peripheral bloodstream might modulate leukemic p...
Source: Clinical Immunology - Category: Allergy & Immunology Authors: Tags: Clin Immunol Source Type: research
A man in his 60s with a history of allogenic hematopoietic stem cell transplant for acute myelogenous leukemia presents with asymptomatic green-gray nodules and plaques on the chest. What is your diagnosis?
Source: JAMA Dermatology - Category: Dermatology Source Type: research
ConclusionThe introduction of a protocol promoting restrictive use of EAT resulted in reduction of carbapenem and vancomycin use and appears to be safe in AML or high-risk MDS patients with febrile neutropenia during chemotherapy or SCT.
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
Abstract We analyzed clinical cutoffs for defining computed tomography (CT) methods for sarcopenia and examined the prognostic value of CT for allogeneic hematopoietic stem cell transplantation (allo-HCST) outcomes of patients with myeloid malignancy. One hundred twenty-five adult patients with acute myeloid leukemia and myelodysplastic syndrome who underwent first allo-HSCT between 2000 and 2017 were included. Sarcopenia was assessed using CT-based skeletal muscle index (SMI) and mean muscle attenuation at L3. A statistical difference in SMI was confirmed between sarcopenia (n = 52) and nonsarcopeni...
Source: International Journal of Hematology - Category: Hematology Authors: Tags: Int J Hematol Source Type: research
g P Abstract The myelodysplastic syndromes (MDS) share an origin in the hematopoietic stem cell but have otherwise very heterogeneous biological and genetic characteristics. Clinical features are dominated by cytopenia and substantial risk for progression to acute myeloid leukemia. According to the World Health Organisation (WHO) MDS is defined by cytopenia, bone marrow dysplasia, and by certain karyotypic abnormalities. The understanding of disease pathogenesis has undergone major development with the implementation of next generation sequencing, and a closer integration of morphology, cytogenetics and molecular ...
Source: Haematologica - Category: Hematology Authors: Tags: Haematologica Source Type: research
CONCLUSIONS: We conclude that the ATG + PTCy combination significantly improved GRFS in allogeneic HCT for high-risk AML and MDS without influencing other outcomes. PMID: 32428903 [PubMed - as supplied by publisher]
Source: Acta Haematologica - Category: Hematology Authors: Tags: Acta Haematol Source Type: research
Shwachman-Diamond syndrome (SDS) is a rare autosomal recessive disorder characterized by bone marrow failure (BMF; cytopenia or aplastic anemia), exocrine pancreatic insufficiency, and skeletal abnormalities, with a predisposition to myelodysplasia (MDS) and acute myeloid leukemia (AML)1. Although most individuals with SDS have some hematologic manifestations of their disease, the majority of them do not require transplantation. Hematopoietic stem cell transplantation (HSCT), however, remains the only curative therapy for 19-36 % of patients with SDS who develop BMF or transformation to myeloid malignancy.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
With increasing use of allogeneic haematopoietic stem cell transplantation (allo-HSCT) in older populations [1,2,3,4,5,6,7], identifying factors which predict for improved outcomes are essential not only with respect to survival but also to ensure good quality of life (QoL) is maintained. In patients undergoing allo-HSCT, impaired QoL is reported in the early stages post-transplant [8,9,10,11]. Improvement in QoL is demonstrated on longer follow up with pre-transplant levels reached by 1 year post HSCT [9,10,11,12].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
With increasing use of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in older populations [1-7], identifying factors predictive of improved outcomes is essential not only with respect to survival, but also to ensure maintenance of good quality of life (QoL). In patients undergoing allo-HSCT, impaired QoL is frequently reported in the early stages post-transplantation [8-11]. Improvement in QoL is demonstrated on longer follow-up, with pretransplantation levels reached by 1 year post-HSCT [9-12].
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Fifty ‐two patients with relapsed/refractory acute myeloid leukemia (AML) were treated with clofarabine, cytarabine, and mitoxantrone. The overall response rate (ORR) was 90.4% (complete remission, CR: 69.2%; CR with incomplete hematological recovery, CRi: 21.2%), with 22 CR/CRi patients undergoing allo geneic hematopoietic stem cell transplantation (allo‐HSCT), while in CR; resulting in a 2‐year OS of 84.3% in CR patients and 90% in patients receiving allo‐HSCT. Clofarabine, cytarabine, and mitoxantrone resulted in high ORR and was safe in refractory/relapsed AML. AbstractClofarabine is active in refractory/relaps...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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