scholarly journals Survival of Mexican Children with Acute Myeloid Leukaemia Who Received Early Intensification Chemotherapy and an Autologous Transplant

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Elva Jiménez-Hernández ◽  
María Teresa Dueñas-González ◽  
José Arellano-Galindo ◽  
María Elena Medrano-Ortíz-De-Zárate ◽  
Vilma Carolina Bekker-Méndez ◽  
...  
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Latin American ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Autologous Transplant ◽  
Group A ◽  
Intensified Chemotherapy ◽  
Group B ◽  
Acute Myeloid

Background. In Mexico and other developing countries, few reports of the survival of children with acute leukaemia exist.Objective. We aimed at comparing the disease-free survival of children with acute myeloid leukaemia who, in addition to being treated with the Latin American protocol of chemotherapy and an autologous transplant, either underwent early intensified chemotherapy or did not undergo such treatment.Procedure. This was a cohort study with a historical control group, forty patients, less than 16 years old. Group A (20 patients), diagnosed in the period 2005–2007, was treated with the Latin American protocol of chemotherapy with an autologous transplant plus early intensified chemotherapy: high doses of cytarabine and mitoxantrone. Group B (20 patients), diagnosed in the period 1999–2004, was treated as Group A, but without the early intensified chemotherapy.Results. Relapse-free survival for Group A was 90% whereas that for Group B it was 60% (P=0.041). Overall survival for Group A (18, 90%) was higher than that for Group B (60%). Complete remission continued for two years of follow-up.Conclusions. Relapse-free survival for paediatric patients treated with the Latin American protocol of chemotherapy with an autologous transplant plus early intensified chemotherapy was higher than that for those who did not receive early intensified chemotherapy.

scholarly journals Clinico-Haematologic association and prognostic relevance of NPM1 and FLT3-ITD mutations in acute Myeloid Leukaemia

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Rafia Mahmood ◽  
Chaudhry Altaf ◽  
Hamid Saeed Malik ◽  
Saleem Ahmad Khan
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Disease Free Survival ◽  
Npm1 Mutation ◽  
Free Survival ◽  
Positive Group ◽  
Median Disease Free Survival ◽  
Prognostic Relevance ◽  
Disease Free ◽  
Acute Myeloid

Background & Objectives: Molecular genetic abnormalities have a significant role not only in diagnosis but also in determining the clinical course and prognosis. Nucleophosmin-1 (NPM-1) is associated with good prognosis while internal tandem duplication of the fms-like tyrosine kinase-3 gene (FLT3-ITD) confers a poor prognosis. Knowledge of the status of these mutations in AML patients not only guides treatment decisions but also helps in predicting response to frontline induction and consolidation chemotherapy as well as the risk of relapse and overall survival. Our objectives were to determine the prevalence, clinico-haematological features and immunophenotypic characteristics of AML patients with FLT3-ITD and NPM1 mutation and to evaluate the response to induction therapy (CR) and disease free survival (DFS) in this cohort of patients. Methods: Patients diagnosed as AML from March 2015 to March 2017 at Armed Forces Institute of Pathology Rawalpindi were included in the study. Clinico-haematologic and immunophenotypic parameters were noted and molecular analysis for FLT3-ITD and NPM1 mutation was performed. Any correlation with cytogenetics or other molecular markers was also studied. Response to standard induction chemotherapy and disease-free survival were assessed. Results: A total of 108 cases of AML were analyzed. Median age was 35 years and 64.8% were males. The median age of the study group was 35 years. Of these, 70 (64.8%) were males while 38 (35.2%) were females. Twenty-nine (26.9%) patients were NPM1 positive, twelve (11.1%) were FLT3-ITD positive while eight (7.4%) were positive for both mutations. Patients with NPM1 mutations were associated with female gender, higher haemoglobin level and platelet counts while those with FLT3-ITD mutations were predominantly seen in male patients and had significantly higher WBC counts, bone marrow blasts, biopsy cellularity and LDH levels. CR rates of NPM1 positive, FLT3-ITD positive and both mutation positive groups were 72%, 60% and 71%, respectively. The median disease-free survival was significantly lower in the FLT3-ITD positive group (7.1 months) as compared to the NPM1 positive group (16.1 months). The median disease-free survival was 12 months and 11.9 months in the NPM1 positive/FLT3-ITD positive and the NPM1 negative/FLT3-ITD negative groups, respectively. Conclusion: AML patients harbouring NPM1 and FLT3-ITD mutations have distinct clinical and haematological characteristics. NPM1 mutations have a better CR and DFS as compared to FLT3-ITD group. How to cite this:Mahmood R, Altaf C, Malik HS, Khan SA. Clinico-Haematologic association and prognostic relevance of NPM1 and FLT3-ITD mutations in acute Myeloid Leukaemia. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.285 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Early Absolute Lymphocyte Count Is a Strong Predictor of Long Term Improved Survival in Childhood Acute Myeloid Leukaemia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3553-3553
Author(s):  
Russell Keenan ◽  
Rebecca Williamson ◽  
Mark Caswell ◽  
Rahuman Salim ◽  
Helen Jane Campbell
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Antigen Processing ◽  
Absolute Lymphocyte Count ◽  
Threshold Value ◽  
Event Free Survival ◽  
Free Survival ◽  
Acute Myeloid

Abstract Abstract 3553 The absolute lymphocyte count (ALC) has been shown to be a predictor of event free survival in the post transplant setting in many diseases including lymphoma, myeloma and leukaemia. (Porrata et al). Studies carried out at Alder Hey Childrens' Hospital, Liverpool in 2003 was the first one of its kind in looking at the ALC as a prognostic tool in the non-bone marrow transplantation setting in childhood leukaemia (Lomas et al, Hudson et al). The studies in acute myeloid leukaemia were small with short follow up. We present here the largest study of the prognostic significance of ALC in paediatric Acute Myeloid Leukaemia. We perfomed a retrospective single centre study involving 59 paediatric patients diagnosed with Acute Myeloid Leukaemia between 1985 and 2010 and treated using Medical Research Council AML 10, AML 12 and AML 15 protocols. Data was analysed for event free and overall survival. All 28 deaths occurred within 3 years. Follow up was 11 months to 27 years in the 31 survivors. A clear relationship was observed between patients with higher absolute lymphocyte counts and overall and event-free survival At 28 days post course 1 chemotherapy, using an ALC threshold value of 1.35 × 109/L, overall survival is 82% v 47% (p = 0.0336). The effect of the ALC diminishes with subsequent chemotherapy courses. At 28 days post course 2 chemotherapy using an ALC threshold value of 1.22 × 109/L, overall survival is 65% v 36% (p = 0.2952). At 28 days post course 4 chemotherapy using an ALC threshold of 0.67 × 109/L, overall survival is 69% v 50% p = 0.5983. We hypothesise that the higher ALC in the event-free patients, is due to tumour specific lymphocyte proliferation, causing clearance of low levels of leukaemia after chemotherapy. The chemotherapy acts to cause leukaemia cell death and antigen processing through macrophages. Chemotherapy causes tissue damage leading to upregulation of immunological danger signals with T and B lymphocyte expansion with specificity against the residual leukaemia cells. The reduced effect of the ALC predicting survival with each subsequent course of therapy may be a result of less leukaemia cells being present prior to each course. Less leukaemia cell death with each course results in less leukaemia antigen processing, presentation and lymphocyte expansion. If this hypothesis is confirmed it may be possible to carry out harvesting of tumour specific lymphocytes prior to chemotherapy with post chemotherapy add back to enhance the curative effect. Disclosures: No relevant conflicts of interest to declare.

Randomized controlled phase II study of alternate-day S-1 as adjuvant chemotherapy for gastric cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 114-114
Author(s):  
Seiichi Nakamura ◽  
Shigeru Tatebe ◽  
Tetsu Shimizu ◽  
Nariyuki Yamane ◽  
Hideaki Nishidoi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Dose Intensity ◽  
Treatment Completion ◽  
Completion Rate ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Group A ◽  
Group B

114 Background: Based on the results of ACTS-GC, oral administration of S-1 for 1 year is considered standard postoperative adjuvant chemotherapy for gastric cancer in Japan. However, the 1-year treatment completion rate was only 65.8%, and completion of the treatment is a problem to be solved. On the other hand, we experienced in clinical practice that the alternate-day administration of S-1 reduced adverse effects and was tolerable for advanced gastric cancer patients unwilling to continue the standard daily administration. We therefore conducted a multi-center cooperative prospective study to compare daily with alternate-day administration of S-1 as postoperative adjuvant therapy for gastric cancer. Methods: Patients with Stage II or III gastric cancer who underwent curative surgery were randomly assigned to receive standard daily administration (group A: S-1 80-120 mg/day according to BSA, days 1 to 28, every 6weeks, for 1 year) or alternate-day administration of S-1 (group B: S-1 80-120 mg/day according to BSA, every other day, for 15 months). The primary endpoints were treatment completion rate and relative dose intensity. Secondary endpoints were safety, overall survival, and relapse-free survival. Results: A total of 73 patients were enrolled. As of August 30, 2011 analysis of the compliance data of 62 cases had been completed. The results showed a treatment completion rate of 74.2% in group A and 93.5% in group B and relative dose intensity of 72.1% in group A and 85.6% in group B, and compliance tended to be better in group B. Assessment of survival time showed a median follow-up time of 545 days, a 1-year survival rate of 93.8% in group A and 96.9% in group B and 1-year relapse-free survival rate of 79.5% in group A and 90.7% in group B. Digestive system adverse events were less frequent in group B than in group A. Conclusions: We will report the data from the final analysis at this meeting. The current data show improved compliance and mitigation of adverse effects with alternate-day administration of S-1, and it appears to be a more sustainable option for adjuvant chemotherapy for Stage II and III gastric cancer.

High-Dose Cytarabine Alone Versus Cytarabine Plus Anthracycline for Consolidation Therapy in Non-Promyelocytic Acute Myeloid Leukemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4890-4890
Author(s):  
Sung-Hyun Kim ◽  
So Yeon Kim ◽  
Ji Hyun Lee ◽  
Suee Lee ◽  
Sung Yong Oh ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
High Dose ◽  
Consolidation Therapy ◽  
Free Survival ◽  
High Dose Cytarabine ◽  
Group A ◽  
Group B ◽  
Acute Myeloid ◽  
Intermediate Dose

Abstract Standard consolidation therapy of acute myeloid leukemia (AML) contains high-dose cytarabine (HiDC). However, optimal dose of cytarabine and benefit of additional chemotherapeutic agents remain unresolved problems. One hundred and forty-two patients among 173 newly diagnosed AML patients, who achieved complete remission following induction chemotherapy and subsequently received different consolidation therapies in 4 independent institutes, were retrospectively analyzed. Patients were divided into 3 groups by consolidation regimens: HiDC (1.5-3g/m2, bid, Days 1,3,5) alone in 44 patients (Group A), HiDC plus anthracycline in 46 patients (Group B), and intermediate-dose cytarabine (1g/m2, bid, Days 1,3,5) plus anthracycline in 52 patients (Group C). Overall survival (OS), relapse-free survival (RFS), disease-free survival (DFS), and event-free survival (EFS), were not significantly different in Group A vs. Group B. However, Group B showed longer RFS, DFS, and EFS, as compared with Group C. Treatment-related mortality was significantly higher in Group B, as compared with Group A (P=0.040) and Group C (P=0.013). Cytogenetic risk was the only significant prognostic factor in OS, RFS, DFS and EFS. In this study, the addition of anthracycline to HiDC as consolidation chemotherapy in AML patients did not improve treatment outcomes, and had more toxicity. HiDC enhanced RFS, DFS, and EFS, as compared with intermediate-dose cytarabine. Therefore, HiDC single therapy could be considered as standard consolidation therapy for non-promyelocytic AML Disclosures Choi: Alexion Pharmaceuticals: Research Funding.

Rapid Remission Induction and Improved Disease Free Survival in Acute Myeloid Leukaemia Using Daunorubicin, ARA-C, and CCNU

1990 ◽  
Vol 3 (2) ◽  
pp. 139-144 ◽  
Author(s):  
A. J. Barrett ◽  
J. G. Treleaven ◽  
D. M. Samson ◽  
M. Evans ◽  
E. Gaminara ◽  
...  
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Disease Free Survival ◽  
Remission Induction ◽  
Free Survival ◽  
Disease Free ◽  
Acute Myeloid
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