Impact of the Presence of An Internal Tandem Duplicate of FlT3 Receptor (ITD) on the Outcome of Adult Patients with Acute Myelocytic Leukemia (AML) Autografted In First Remission (CR1)Norbert-Claude Gorin, Myriam Labopin, Jordi Esteve, and Mohamad Mohty, on Behalf of the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3556-3556
Author(s):  
Norbert C. Gorin ◽  
Myriam Labopin ◽  
Jordi Esteve ◽  
Mohamad Mohty
Keyword(s):  
Working Party ◽  
Adult Patients ◽  
High Dose ◽  
Acute Myelocytic Leukemia ◽  
Blood And Marrow Transplantation ◽  
Myelocytic Leukemia ◽  
Cell Counts ◽  
First Remission ◽  
Negative Population

Abstract Abstract 3556 The prognosis of patients with AML harbouring the FlT3 ITD is known to be poor in patients treated with chemotherapy only. However it remains uncertain whether it also has an impact on outcome following high dose intensification and autologous stem cell transplantation (ASCT).We adressed the question using the EBMT data base. Information on the presence or the absence of FlT3ITD was available in 134 adult patients with AML who were autografted in CR1 in the period of January 1999 to December 2009. 76 patients (42 with normal karyotypes) were ITD negative and 58 (36 with normal karyotypes) were ITD positive. 90% of the patients received peripheral blood as a source of stem cells. The follow up was 30 mo (1-139).Patients ITD positive were older than patients ITD negative (52.8 vs 47.4 years; p=0.009)and their White cell counts at diagnosis were higher (52 vs 10.9 109/l; p<0.0001).For the 134 patients, the 3 year leukemia free survival (LFS) was 42 ± 5%, the relapse incidence (RI) 53 ± 4% and the non relapse mortality (NRM) 6 ±3%.Patients positive for Flt3ITD had a 3 year LFS of 34±7% vs 46±6% in those with no ITD (p=0.12), and a RI of 62±7% vs 45±6% (p=0.051). In Patients with ITD, age was the only significant poor risk factor with a LFS of 20 ± 9% in those older than 53 years (median) vs 46±10% in those younger. Further studies are needed with a larger patient population to draw valuable conclusions. However, these results suggest that while ASCT is of little benefit to older patients, it remains valuable in younger patients with AML harbouring the FlT3ITD, in whom the outcome does not differ from the ITD negative population. Disclosures: Mohty: Genzyme: Consultancy, Honoraria, None, Research Funding, Speakers Bureau; Amgen: Consultancy, Honoraria; Janssen Cilag: Consultancy, Honoraria; Celgene: Honoraria.

Identical Outcome After Autologous or Allogeneic Genoidentical Hematopoietic Stem-Cell Transplantation in First Remission of Acute Myelocytic Leukemia Carrying Inversion 16 or t(8;21): A Retrospective Study From the European Cooperative Group for Blood and Marrow Transplantation

2008 ◽  
Vol 26 (19) ◽  
pp. 3183-3188 ◽  
Author(s):  
Norbert-Claude Gorin ◽  
Myriam Labopin ◽  
Francesco Frassoni ◽  
Noel Milpied ◽  
Michel Attal ◽  
...  
Keyword(s):  
Chromosomal Abnormalities ◽  
Autologous Transplantation ◽  
Initial Response ◽  
Allogeneic Transplantation ◽  
High Dose ◽  
Acute Myelocytic Leukemia ◽  
Hematopoietic Stem ◽  
Myelocytic Leukemia ◽  
First Remission ◽  
Additional Chromosomal Abnormalities

Purpose Patients with acute myelocytic leukemia carrying inversion 16 (inv16) or t(8;21) have a better initial response to high-dose cytarabine than patients without these chromosomal abnormalities. They presently do not undergo transplantation in first remission (CR1), but there is concern about late relapses. Patients and Methods From 1990 to 2004, 325 adult patients received transplantations in CR1 (159 patients with inv16 and 166 patients with t(8;21), including 35 and 60 patients, respectively, with additional chromosomal abnormalities). Genoidentical allografts were performed in 64 patients with inv16 and 81 patients with t(8;21), and autografts were performed in 95 patients with inv16 and 85 patients with t(8;21). Results In patients with inv16, after allogeneic and autologous transplantation, the 5-year leukemia-free survival (LFS) rates were 59% and 66% (P = .5), the relapse incidence (RI) rates were 27% and 32% (P = .45), and the transplantation-related mortality (TRM) rates were 14% and 2% (P = .003), respectively. Female patients had a lower RI and a higher LFS. Additional chromosomal abnormalities, compared with no additional abnormalities, were associated with lower RI rate (12% v 34%, respectively; P = .01) and higher 5-year LFS rate (78% v 59%, respectively; P = .04). In patients with t(8;21), after allogeneic and autologous transplantation, the 5-year LFS rates were 60% and 66% (P = .69), the RI rates were 15% and 28% (P = .03), and the TRM rates were 24% and 6% (P = .003), respectively. Younger age and a lower WBC count at diagnosis were associated with a lower TRM and a better LFS. The TRM was lower and the RI was higher in patients with autologous transplantations versus allogeneic transplantations. Conclusion Both autologous and allogeneic transplantation resulted in similar outcomes.

scholarly journals Impact of FLT3 ITD/NPM1 mutation status in adult patients with acute myelocytic leukemia autografted in first remission

Haematologica ◽  
2012 ◽  
Vol 98 (2) ◽  
pp. e12-e14 ◽  
Author(s):  
N.-C. Gorin ◽  
M. Labopin ◽  
G. Meloni ◽  
A. Pigneux ◽  
J. Esteve ◽  
...  
Keyword(s):  
Adult Patients ◽  
Acute Myelocytic Leukemia ◽  
Npm1 Mutation ◽  
Mutation Status ◽  
Myelocytic Leukemia ◽  
First Remission

Higher Incidence of Relapse With Peripheral Blood Rather Than Marrow As a Source of Stem Cells in Adults With Acute Myelocytic Leukemia Autografted During the First Remission

2009 ◽  
Vol 27 (24) ◽  
pp. 3987-3993 ◽  
Author(s):  
Norbert-Claude Gorin ◽  
Myriam Labopin ◽  
Didier Blaise ◽  
Josy Reiffers ◽  
Giovanna Meloni ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Randomized Study ◽  
Research Data ◽  
Acute Myelocytic Leukemia ◽  
Free Survival ◽  
Blood And Marrow Transplantation ◽  
Myelocytic Leukemia ◽  
Cell Source ◽  
First Remission ◽  
First Complete Remission

Purpose The cell source for autologous stem cell transplantation has shifted from bone marrow (BM) to peripheral blood (PB). In acute myelocytic leukemia (AML), for patients who receive transplants during first complete remission (CR1), no prospective randomized study has compared relapse incidence (RI) to cell source. Patients and Methods We analyzed 2,165 patients who received autografts (1,607 PB and 558 BM) from 1994 to 2006 and were reported to the European Cooperative Group for Blood and Marrow Transplantation with complete research data. Relative to the time of CR1, PB transplants were performed earlier than BM transplants. Because a poorer outcome was associated with a shorter interval from CR1 to transplantation, patients were divided into three groups: BM, early PB (≤ 80 days after CR1), and late PB (> 80 days after CR1) transplantation. Results In a multivariate analysis adjusted for differences between groups and center, RI was higher with both early PB (56% ± 3%; hazard ratio [HR], 1.45; 95% CI, 1.11 to 1.9; P = .006) and late PB transplantation (46% ± 2%; HR, 1.3; 95% CI, 1.06 to 1.59; P = .01) as compared with BM transplantation (39% ± 2%). This translated into a significantly worse leukemia-free survival (LFS) for early PB transplantation (36% ± 3%; HR, 0.75; 95% CI, 0.58 to 0.96; P = .02) and a trend for a poorer LFS for late PB (46% ± 2%; HR, 0.84; 95% CI, 0.7 to 1.01; P = .06) as compared with BM (52% ± 2%). Conclusion For patients with AML in CR1, risk of relapse is greater with PB transplantation rather than BM, independent of the interval from CR1 to transplantation.

scholarly journals Two-cycle timed-sequential chemotherapy for adult acute nonlymphocytic leukemia

Blood ◽  
1984 ◽  
Vol 64 (5) ◽  
pp. 975-980
Author(s):  
WP Vaughan ◽  
JE Karp ◽  
PJ Burke
Keyword(s):  
Complete Remission ◽  
Leukemia Cell ◽  
High Dose ◽  
Acute Nonlymphocytic Leukemia ◽  
Single Cycle ◽  
Number Of Patients ◽  
Dose Infusion ◽  
First Remission ◽  
Sequential Regimen

Based on a series of clinical and laboratory studies of leukemia cell kinetics and responses to chemotherapy, we have developed an intensive timed-sequential regimen of daunorubicin and high-dose infusion 1-beta- D-arabinofuranosyl cytosine for the treatment of adult acute nonlymphocytic leukemia. Of the first 34 patients achieving complete remission (CR) with a single cycle of this therapy, four (12%) remain in complete remission without further therapy after a minimum of five years of follow-up. Treatment of relapsed patients with a second course of the same regimen at relapse and no chemotherapy in second remission increased to seven (21%) the number of patients expected to remain in remission for four years or more from their last chemotherapy. Beginning in 1980, however, we gave all consenting adults a second cycle of this chemotherapy in early first remission. Of the first 25 patients treated with a second cycle of this chemotherapy in early first remission, there was one toxic death, but 11 patients (44%) remain in CR with a median follow-up of almost three years.

Autologous bone marrow transplantation for adult poor-risk lymphoblastic lymphoma in first remission.

1992 ◽  
Vol 10 (4) ◽  
pp. 644-646 ◽  
Author(s):  
L F Verdonck ◽  
A W Dekker ◽  
G C de Gast ◽  
H M Lokhorst ◽  
H K Nieuwenhuis
Keyword(s):  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
Lymphoblastic Lymphoma ◽  
Adult Patients ◽  
High Dose ◽  
Consolidation Therapy ◽  
Poor Risk ◽  
First Remission ◽  
Autologous Bone

PURPOSE Adult patients with poor-risk lymphoblastic lymphoma (LBL) treated with intensive multiagent chemotherapy (acute lymphoblastic leukemia [ALL]-like regimens) have a poor prognosis, with a disease-free long-term survival rate of less than 20%, caused by a very high relapse rate. Thus, adult patients with poor-risk LBL are candidates for alternative intensive consolidation therapy. PATIENTS AND METHODS Nine adult patients with poor-risk LBL in first remission after treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP; six patients) or ALL-like regimens (three patients), were treated with high-dose cyclophosphamide and total body irradiation (TBI) followed by nonpurged autologous bone marrow transplantation (ABMT). RESULTS Two of nine patients relapsed at 4 and 8 months, respectively, after BMT, and one patient died of acute myeloblastic leukemia (AML) 7 months after ABMT without recurrence of his lymphoma. Six patients are in unmaintained first remission with a follow-up of 12 to 113 months (median, 53 months) after transplantation. CONCLUSIONS These results suggest that intensive consolidation therapy with high-dose cyclophosphamide and TBI followed by nonpurged ABMT may improve the long-term prognosis of this disease.

scholarly journals Two-cycle timed-sequential chemotherapy for adult acute nonlymphocytic leukemia

Blood ◽  
1984 ◽  
Vol 64 (5) ◽  
pp. 975-980 ◽  
Author(s):  
WP Vaughan ◽  
JE Karp ◽  
PJ Burke
Keyword(s):  
Complete Remission ◽  
Leukemia Cell ◽  
High Dose ◽  
Acute Nonlymphocytic Leukemia ◽  
Single Cycle ◽  
Number Of Patients ◽  
Dose Infusion ◽  
First Remission ◽  
Sequential Regimen

Abstract Based on a series of clinical and laboratory studies of leukemia cell kinetics and responses to chemotherapy, we have developed an intensive timed-sequential regimen of daunorubicin and high-dose infusion 1-beta- D-arabinofuranosyl cytosine for the treatment of adult acute nonlymphocytic leukemia. Of the first 34 patients achieving complete remission (CR) with a single cycle of this therapy, four (12%) remain in complete remission without further therapy after a minimum of five years of follow-up. Treatment of relapsed patients with a second course of the same regimen at relapse and no chemotherapy in second remission increased to seven (21%) the number of patients expected to remain in remission for four years or more from their last chemotherapy. Beginning in 1980, however, we gave all consenting adults a second cycle of this chemotherapy in early first remission. Of the first 25 patients treated with a second cycle of this chemotherapy in early first remission, there was one toxic death, but 11 patients (44%) remain in CR with a median follow-up of almost three years.

Sign in / Sign up

Export Citation Format

Share Document