Outcome Of Patients With Acute Myeloid Leukemia/High Risk MDS According To The Kidney Function

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5007-5007
Author(s):  
Ahmed Malkawi ◽  
Ankit Anand ◽  
Ali Al-Ameri ◽  
Mohamed Abdelfatah ◽  
Zeyad Kanaan ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Survival Analysis ◽  
Glomerular Filtration Rate ◽  
High Risk ◽  
Glomerular Filtration ◽  
Myeloid Leukemia ◽  
Filtration Rate ◽  
Myelogenous Leukemia ◽  
Number Of Patients ◽  
Acute Myeloid

Abstract Background Acute renal failure or injury is a common complication of treatment of patients with acute myelogenous leukemia (AML) or high risk MDS, but the effect of renal function of patients who have acute myeloid leukemia/high risk MDS is not clearly highlighted as a predictor of survival, to the best of our knowledge this issue has not been studied in depth before. Aim study the effect of chronic kidney disease on the survival of patient with acute myeloid leukemia/High Risk MDS. Methods A retrospective study of all AML & high risk MDS patients treated at AGMC, Ohio, USA during 2001-2010. After IRB approval of the project, patients’ charts were reviewed to gather information on demographics, diagnosis types/subtypes, glomerular filtration rate (GFR), treatment, and cytogenetics. Patients were classified as low-intermediate risk or high risk according to cytogenetic background using WHO criteria. Also according to GFR patients were classified to GFR <30, 30 - 60 and > 60. Overall survival (OS) rates were determined by Kaplan-Meier Survival Analysis. Prognostic factors were evaluated by Log Rank analysis. Result Out of 130 patients we were able to classify 99 patients (75%). Patient were grouped into 59 Pts with GFR>60, 37 Pts with GFR 30-60 and 3 Pts with GFR<30. Time to event survival analysis was done. Conclusion Glomerular filtration rate GFR is a major identified factor in patients survival who have acute myeloid leukemia AML/High Risk MDS, those patients with GFR 30-60 do better in term of survival, we don’t have any explanation for that, more data with high number of patients needed to elaborate on this issue. Disclosures: No relevant conflicts of interest to declare.

Outcome Of Patients With Acute Myeloid Leukemia/High Risk Myelodysplastic Syndrome Based On Bone Mineral Density: Data From a Single center 2000-2012

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5008-5008
Author(s):  
Ankit Anand ◽  
Hussam Al-sharif ◽  
Mohamed Abdelfatah ◽  
Nairmeen Haller ◽  
Ali Al-Ameri
Keyword(s):  
Bone Mineral Density ◽  
Acute Myeloid Leukemia ◽  
Survival Analysis ◽  
High Risk ◽  
Bone Density ◽  
Bone Mineral ◽  
Myeloid Leukemia ◽  
X Rays ◽  
Mineral Density ◽  
Acute Myeloid

Abstract Background Acute myeloid leukemia results from clonal proliferation of myeloid precursors, resulting in accumulation of leukemic blasts in the bone marrow. The effect of leukemic blasts in the bone have not been well studied. It is hypothesized that leukemic blasts may affect the osteoblast and osteoclast balance. Aim The aim of this study is to describe the effect of osteoporosis/osteopenia on the survival of patients with AML/ high risk MDS Methods A retrospective study of all AML and high-risk MDS patients treated at Akron General Medical Center, Ohio during 2001-2012. Following IRB approval, patients' charts were reviewed for information on demographics, cytogenetics, and treatment. Patients were classified into low risk, intermediate risk and high risk MDS based on WHO criteria. Charts were reviewed for a diagnosis of osteoporosis/osteopenia. Overall survival rates were determined by Kaplan-Meier survival analysis. Patients were classified into osteopenia/osteoporosis based on bone density scans. An additional three patients were identified with osteopenia on the basis of lumbar X rays and one patient was diagnosed with osteoporosis on the basis of typical compression fracture for osteoporosis. Results During the study period, 187 patients were identified with AML/high risk MDS. A total of 31 patients were found to have osteopenia/osteoporosis based on radiological findings. Eight patients had osteoporosis and 24 patients had osteopenia. A survival analysis was performed on the study population based on bone mineral density. Group one (osteoporosis) included eight patients; group two (osteopenia) included 23 patients and group three (no radiological evidence of osteoporosis/osteopenia) included 156 patients. Results are depicted in the survival curve below. Conclusions Bone mineral density remains an unidentified factor in patient's survival, suffering from AML/ High risk MDS. It appears that patients with normal bone density may live longer than patients with osteopenia/osteoporosis, but this is not confirmed here statistically. Future studies with a larger patient sample may be helpful in further exploring this aspect and the role of bisphosphonates in patients with AML/high risk MDS. Disclosures: No relevant conflicts of interest to declare.

Phenotypic Aberrations of Myeloid CD34+ Cells in Patients with Myelodysplastic Syndrome (MDS): Clinical Significance and Correlation with Cytogenetics Abnormalities.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2374-2374
Author(s):  
Dolores Subira ◽  
Patricia Font ◽  
Eva Arranz ◽  
Ramiro B Soraya ◽  
Susana Castanon ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
High Risk ◽  
Myeloid Leukemia ◽  
Fish Analysis ◽  
Aberrant Expression ◽  
Number Of Patients ◽  
Cd34 Cells ◽  
Design And Methods ◽  
Acute Myeloid

Abstract Expression of abnormal markers in myeloid CD34+ cells of patients with MDS is common, but few immunophenotypic data have been compiled so far. Based on the statement that CD7 and TdT are markers associated with a bad prognosis in acute myeloid leukemia, we intended to describe the incidence of their aberrant expression in CD34+ cells and its role helping to establish the diagnosis of MDS. OBJECTIVES: To explore the aberrant expression of TdT and CD7 in myeloid CD34+ cells of MDS patients and to describe their possible correlation with cytogenetic features. DESIGN AND METHODS: Bone marrow specimens from 45 patients with MDS were included in this study (17 RA, 12 RARS, 5 CMML, 9 RAEB, 2 RAEB-t). In addition, we analyzed 28 samples of bone marrow from patients with cytopenias, but no diagnosis of MDS, as a cohort control. Immunophenotyping was performed with the following combination of monoclonal antibodies: TdT FITC / CD7 PE/ CD34 PCy-5. A case was regarded as positive for any of these markers when their expression was described in at least, 25% of myeloid CD34+ cells. Besides, adequate cytogenetic data and FISH analysis of chromosomes 5, 7 and 8 were obtained from 42 out of the 45 MDS samples. RESULTS: The percentage of CD34+ myeloid cells in MDS samples was fewer than 2% in 25 cases, ranged from 2–5% in 6 cases and was equal or greater than 5% in 14 cases. Aberrant expression of CD7 and/or TdT was observed in 28 cases: 20 were positive for CD7, 5 cases were positive for TdT and co-expression of both antigens was described in 3 cases. Prevalence of these abnormal markers was much higher in patients with MDS (28/45; 62%) than in the cohort control (2/28; 7%) . Besides, we identified at least one abnormal marker in 14 of the 16 patients with high risk MDS (9 RAEB, 5 CMML, 2 RAEB.t). According to the IPSS, karyotypes were divided into subgroups of favorable, intermediate or unfavorable, being classified 29 patients with favorable karyotypes and 13 patients with no favorable cytogenetics. In the first group, the abnormal expression of CD7 and/or TdT was detected in 13/29 patients (44.8%) and in 10/13 patients in the non-favourable group (76.9%). CONCLUSIONS: CD7 and/or TdT expression in myeloid CD34 + cells may be helpful in establishing the diagnosis of MDS. Prevalence of these aberrancies seems to be higher in cases with no favorable karyotypes, but a larger number of patients will be required to state significant differences. Possible correlation between high risk MDS patients and immunophenotypic aberrancies suggests the convenience of following the outcome of those low risk MDS patients who have expression of any of these abnormal markers.

Induction Intensified Regimens Including Fludarabine or Mylotarg for Acute Myeloid Leukemia Patients: Comparison by Response and Follow-up.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 941-941
Author(s):  
Cristina Papayannidis ◽  
Anna Candoni ◽  
Stefania Paolini ◽  
Emanuela Ottaviani ◽  
Ilaria Iacobucci ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
High Risk ◽  
Complete Remission ◽  
Median Time ◽  
Induction Therapy ◽  
Safety Profile ◽  
Myeloid Leukemia ◽  
Number Of Patients ◽  
Acute Myeloid

Abstract Background . Conventional induction treatment in young Acute Myeloid Leukemia (AML) patients (<= 60 years old) is still represented by the association of antracycline and cytarabine, which offers a complete remission (CR) rate not inferior to 63%. Since many non-randomized trials have recently demonstrated the superiority of intensified regimens, the present gold standard therapy includes the addition of at least a third drug to the classic 3/7 schedule. Aim of the study . We evaluated the safety profile and the efficacy of two four-drugs induction schedules, adding either fludarabine (25 mg/sqm days 1–5) or mylotarg (3 mg/sqm day 6) to idarubicin (6 mg/sqm days 1, 3, 5), cytarabine (1 g/sqm days 1–5), etoposide (100 mg/sqm days 1–5) (FLAIE and MyAIE, respectively). Methods . Sixty-six consecutive AML patients were enrolled either in the FLAIE (N=44, from 2002 to 2005) or in the MyAIE (N=22, from 2005 to April 2007) schedule, with similar clinical and biological characteristics. The median age was 45 and 48 years, respectively. According to kariotype, WBC count and FLT3 status, seventy and sixty-four percent of cases, respectively, were considered at high risk. Consolidation therapy consisted of 2 cycles of ID-AraC and Ida. Results . The complete remission rate was 75% and 59% for FLAIE and MyAIE, respectively (p=n.s.). Death during treatment rates were 5% and 0. After 1 consolidation course the overall CR rate was 80% and 73%. After a similar median follow up, 27 months (1–62) and 21 months (5–42) respectively, 41% of patients are alive in CR in the FLAIE group (12 SCT and 3 ASCT) and 64% in the MyAIE group (7 SCT and 4 ASCT) (p=n.s.; Chi-square, Fisher’s exact test). Toxicity was comparable in the two regimens. The median time to ANC recovery (>1.0 x 10^9/L) was 31 and 23 days for FLAIE and MyAIE, respectively. The median time to PLT recovery (>100 x 10^9/L) was 28 and 24 days, respectively. The median time of neutropenic fever episodes for patients was 1 and 1.4 in the 2 groups, respectively. Grade III/IV GI toxicities occurred in 11% and 22% of cases, respectively. Conclusions . These data showed that four-drugs intensified induction therapy is a feasible approach in young AML patients. Recent published trials have demonstrated that fludarabine-based induction chemotherapy in high risk AML patients is able to increase the CR rate offered by conventional treatment. Therefore, the limited number of patients involved in this study, the low administration dosage of idarubicin, and the relevant role of fludarabine in induction therapy, can reasonably justify the lower CR rate obtained in patients treated in the MyAIE schedule, if compared with FLAIE regimen and, above all, with standard chemotherapy. In the light of their efficacy and safety profile, fludarabine and mylotarg, in combination with conventional chemotherapy, represent a promising induction regimen in young AML patients; further analyses and randomized pilot trials will define their definite role.

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