AML-437: Survival of Patients with Secondary Acute Myeloid Leukemia in a University Hospital in Colombia

2021 ◽  
Vol 21 ◽  
pp. S311-S312
Author(s):  
Maria F. Ortiz ◽  
Angela M. Peña ◽  
Luis A. Salazar ◽  
Sara I. Jimenez ◽  
Manuel Rosales ◽  
...  
2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19000-e19000
Author(s):  
Abigail Schmucker ◽  
Benjamin Leiby ◽  
Lindsay Wilde

e19000 Background: The AML-Score has been validated to predict complete remission (CR) and early mortality (EM) in patients receiving traditional induction chemotherapies but not daunorubicin/cytarabine liposome (Vyxeos; Jazz Pharmaceuticals; Palo Alto, CA). We conducted a retrospective analysis to evaluate, among patients with newly diagnosed secondary acute myeloid leukemia (sAML) who received intensive induction with daunorubicin/cytarabine liposome, how accurately the AML-Score predictions associate with observed 1) CR after intensive induction and 2) EM within 60 days after induction initiation. Methods: We abstracted demographic and clinical data from consecutive patients receiving daunorubicin/cytarabine liposome at the Sidney Kimmel Cancer Center at Thomas Jefferson University Hospital between September 2017 and November 2020. We used descriptive statistics with 95% confidence intervals (CIs) and receiver operating curves to characterize the associations between AML-Score predictions and observed rates of CR and EM. Results: In total, 40 patients were included for analysis. 27 (67.5%) were male, 27 (67.5%) were white, 36 (90.0%) were not Hispanic or Latino, and 28 (70.0%) were aged 60-72 years. Twenty-seven patients (67.5%) had a CR, and 4 (10%) experienced early mortality. Observed rates of CR and EM generally increased with increasing predicted risk (Table). The area under the curve was 0.75 (95% CI 0.60-0.90) for CR and 0.82 (95% CI 0.68-0.96) for EM. Conclusions: The AML-Score tool trends in the correct direction in terms of predicting rates of CR and EM, and thus may contribute to oncologist prognostication and treatment planning for patients receiving daunorubicin/cytarabine liposome. However, its clinical utility is limited by the fact that it may underestimate the risk of CR and overestimate the risk of EM. Further study in a larger cohort is needed to update the AML-Score to give accurate point estimates of CR and EM risk in this population. Predicted CR and EM versus Observed CR and EM.[Table: see text]


2021 ◽  
Vol 21 ◽  
pp. S214
Author(s):  
Maria F. Ortiz ◽  
Angela M. Peña ◽  
Luis A. Salazar ◽  
Sara I. Jimenez ◽  
Manuel Rosales ◽  
...  

Author(s):  
Michael Heuser ◽  
B. Douglas Smith ◽  
Walter Fiedler ◽  
Mikkael A. Sekeres ◽  
Pau Montesinos ◽  
...  

AbstractThis analysis from the phase II BRIGHT AML 1003 trial reports the long-term efficacy and safety of glasdegib + low-dose cytarabine (LDAC) in patients with acute myeloid leukemia ineligible for intensive chemotherapy. The multicenter, open-label study randomized (2:1) patients to receive glasdegib + LDAC (de novo, n = 38; secondary acute myeloid leukemia, n = 40) or LDAC alone (de novo, n = 18; secondary acute myeloid leukemia, n = 20). At the time of analysis, 90% of patients had died, with the longest follow-up since randomization 36 months. The combination of glasdegib and LDAC conferred superior overall survival (OS) versus LDAC alone; hazard ratio (HR) 0.495; (95% confidence interval [CI] 0.325–0.752); p = 0.0004; median OS was 8.3 versus 4.3 months. Improvement in OS was consistent across cytogenetic risk groups. In a post-hoc subgroup analysis, a survival trend with glasdegib + LDAC was observed in patients with de novo acute myeloid leukemia (HR 0.720; 95% CI 0.395–1.312; p = 0.14; median OS 6.6 vs 4.3 months) and secondary acute myeloid leukemia (HR 0.287; 95% CI 0.151–0.548; p < 0.0001; median OS 9.1 vs 4.1 months). The incidence of adverse events in the glasdegib + LDAC arm decreased after 90 days’ therapy: 83.7% versus 98.7% during the first 90 days. Glasdegib + LDAC versus LDAC alone continued to demonstrate superior OS in patients with acute myeloid leukemia; the clinical benefit with glasdegib + LDAC was particularly prominent in patients with secondary acute myeloid leukemia. ClinicalTrials.gov identifier: NCT01546038.


Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 186
Author(s):  
Marcus Bauer ◽  
Christoforos Vaxevanis ◽  
Haifa Kathrin Al-Ali ◽  
Nadja Jaekel ◽  
Christin Le Hoa Naumann ◽  
...  

Background: Myelodysplastic syndromes (MDS) are caused by a stem cell failure and often include a dysfunction of the immune system. However, the relationship between spatial immune cell distribution within the bone marrow (BM), in relation to genetic features and the course of disease has not been analyzed in detail. Methods: Histotopography of immune cell subpopulations and their spatial distribution to CD34+ hematopoietic cells was determined by multispectral imaging (MSI) in 147 BM biopsies (BMB) from patients with MDS, secondary acute myeloid leukemia (sAML), and controls. Results: In MDS and sAML samples, a high inter-tumoral immune cell heterogeneity in spatial proximity to CD34+ blasts was found that was independent of genetic alterations, but correlated to blast counts. In controls, no CD8+ and FOXP3+ T cells and only single MUM1p+ B/plasma cells were detected in an area of ≤10 μm to CD34+ HSPC. Conclusions: CD8+ and FOXP3+ T cells are regularly seen in the 10 μm area around CD34+ blasts in MDS/sAML regardless of the course of the disease but lack in the surrounding of CD34+ HSPC in control samples. In addition, the frequencies of immune cell subsets in MDS and sAML BMB differ when compared to control BMB providing novel insights in immune deregulation.


2007 ◽  
Vol 29 (9) ◽  
pp. 646-648 ◽  
Author(s):  
Michael Weintraub ◽  
Shoshana Revel-Vilk ◽  
Mira Charit ◽  
Memet Aker ◽  
Jacob P??er

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