scholarly journals Analysis of Genetic Mutation of the Elderly Patients with Acute Myeloid Leukemia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5172-5172
Author(s):  
Yusuke Fujiwara ◽  
Hiroki Yamaguchi ◽  
Atsushi Marumo ◽  
Ikuko Omori ◽  
Satoshi Yamanaka ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Risk Group ◽  
Gene Mutations ◽  
Direct Sequence ◽  
Poor Prognostic Factor ◽  
Genetic Abnormalities ◽  
Direct Sequence Analysis ◽  
Low Dose Chemotherapy

Abstract Backgrounds: Acute myeloid leukemia (AML) is a heterogeneous disease whose onset involves a variety of chromosomal abnormalities and genetic mutations. To improve the outcome of AML treatment, it is very important to establish a prognosis from cytogenetic and genetic analysis and provide accordingly differentiated treatment. However, the treatment strategy has not been clear in elderly patients with AML due to intolerance of treatment and its adverse characteristics such as concomitant comorbidity and poor performance status. To clarify the prognostic impact of genetic abnormalities in elderly AML, we conducted a comprehensive analysis of recurrently mutated 28 genes in AML. Method: We retrospectively analyzed newly diagnosed 128 AML patients excluding M3 who were more than 65 years old at Nippon Medical School Hospital or its associated facilities between 1990 and 2014. Mutation analyses were performed by direct sequence analysis, Mutation Biased PCR, direct sequence analysis, and the next-generation sequencer Ion PGMTM. Results: Average age was 70.5 years (65-91years). The patients from 65 years old to 74 years old (early elderly) were 92 (71.9%)cases, the patients 75 years or older (late elderly) were 36 (28.1%)cases. Chromosomal analysis according to the prognostic risk classification of the Eastern Cooperative Oncology Group (ECOG) classified into 14 of the favorable cytogenetic risk group (10.9%), 80 of the intermediate cytogenetic risk group (62.5%), and 24 of the poor cytogenetic risk group (18.8%). Gene mutations were observed in 112 cases (87.5%). The most frequent gene mutations were NPM1 (89 cases/28.9%), FLT3/ITD (25 cases/19.5%), TET2 (20 cases/15.6%), and DNMT3A (19 cases/14.8%). CEBPA double mutation was detected at low frequency in elderly patients (younger patients: 15/311 (4.8%) vs elderly patients: 1/128 (0.8%)). There were no significant differences in gene mutations between early elderly and late elderly patients). Of 102 patients who received induction therapy, 52 patients (51.0%) achieved first hematological complete remission (CR), but primary refractory and early death were observed in 50 patients (49.0%). There was no significant difference in CR rate between the two groups in the early elderly patients and late elderly patients (early elderly: 53.8% vs late elderly: 41.7%. p= 0.354). In addition, there was no difference in CR rate in the standard chemotherapy and low dose chemotherapy group (standard chemotherapy: 48.7% vs low dose chemotherapy: 38.9%. p= 0.601). Median overall survival (OS) was 287days, OS at 3years was 35.9%. Prognostic stratification was possible for CR rate on the chromosomal classification (favorable cytogenetic risk 92.9%, intermediate cytogenetic risk 50.0%, poor cytogenetic risk 12.5%, p< 0.001). For total cohort of patients, rates of relapse free survival (RFS) at 3 years are significantly lower in patients with FLT3ITD (p=0.006) and TP53 abnormality (p< 0.001) compared to without it. Rates of overall survival (OS) at 3 years are significantly lower in patients with DNMT3A mutation (p=0.004), FLT3ITD (p=0.003), and TP53 abnormality compared to without it. Also late elderly patients (p=0.010) and high white blood cell count (≥ 20,000/μl) (p=0.023) were powerful factors for unfavorable prognosis. In stratified analysis of FLT3ITD-negative cases aged below 75 years with intermediate cytogenetic prognosis, TP53 abnormality was associated with unfavorable prognosis (RFS: p=0.062, OS: p< 0.001). Finally multivariate analysis demonstrated that FLT3ITD (p=0.014) and TP53 abnormality (p=0.015) were an independent poor prognostic factor for RFS, and poor cytogenetic risk (p=0.002), Flt3ITD (p=0.014), TP53 abnormality (p=0.015), and DNMT3A mutation (p=0.001) were an independent poor prognostic factor for OS. Conclusions: Our results suggest that the genetic abnormalities have a prognostic importance in elderly patients, as well as younger patients with AML. FLT3ITD mutation is an important factor for unfavorable prognosis, but going forward TP53 mutation may also serve as a clinically important gene mutation marker in elderly patients with AML. Disclosures No relevant conflicts of interest to declare.

scholarly journals Immunomodulatory Effect of Green Tea Treatment in Combination with Low-dose Chemotherapy in Elderly Acute Myeloid Leukemia Patients with Myelodysplasia-related Changes

2021 ◽  
Vol 20 ◽  
pp. 153473542110026
Author(s):  
Andrana K. Calgarotto ◽  
Ana L. Longhini ◽  
Fernando V. Pericole de Souza ◽  
Adriana S. Santos Duarte ◽  
Karla P. Ferro ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
T Cell ◽  
Green Tea ◽  
Regulatory T Cell ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Related Factor ◽  
Low Dose Chemotherapy ◽  
Acute Myeloid

Green tea (GT) treatment was evaluated for its effect on the immune and antineoplastic response of elderly acute myeloid leukemia patients with myelodysplasia-related changes (AML-MRC) who are ineligible for aggressive chemotherapy and bone marrow transplants. The eligible patients enrolled in the study (n = 10) received oral doses of GT extract (1000 mg/day) alone or combined with low-dose cytarabine chemotherapy for at least 6 months and/or until progression. Bone marrow (BM) and peripheral blood (PB) were evaluated monthly. Median survival was increased as compared to the control cohort, though not statistically different. Interestingly, improvements in the immunological profile of patients were found. After 30 days, an activated and cytotoxic phenotype was detected: GT increased total and naïve/effector CD8+ T cells, perforin+/granzyme B+ natural killer cells, monocytes, and classical monocytes with increased reactive oxygen species (ROS) production. A reduction in the immunosuppressive profile was also observed: GT reduced TGF-β and IL-4 expression, and decreased regulatory T cell and CXCR4+ regulatory T cell frequencies. ROS levels and CXCR4 expression were reduced in bone marrow CD34+ cells, as well as nuclear factor erythroid 2–related factor 2 (NRF2) and hypoxia-inducible factor 1α (HIF-1α) expression in biopsies. Immune modulation induced by GT appears to occur, regardless of tumor burden, as soon as 30 days after intake and is maintained for up to 180 days, even in the presence of low-dose chemotherapy. This pilot study highlights that GT extracts are safe and could improve the immune system of elderly AML-MRC patients.

scholarly journals The Clinical Features and Prognostic Impact of PRDM16 gene Expression in Adult Acute Myeloid Leukemia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5228-5228
Author(s):  
Genki Yamato ◽  
Hiroki Yamaguchi ◽  
Hiroshi Handa ◽  
Norio Shiba ◽  
Satoshi Wakita ◽  
...  
Keyword(s):  
Gene Expression ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Risk Group ◽  
Gene Mutations ◽  
Genetic Alterations ◽  
Prognostic Impact ◽  
Pediatric Aml ◽  
Prdm16 Gene ◽  
Acute Myeloid

Abstract Background Acute myeloid leukemia (AML) is a complex disease caused by various genetic alterations. Some prognosis-associated cytogenetic aberrations or gene mutations such as FLT3-internal tandem duplication (ITD), t(8;21)(q22;q22)/RUNX1-RUNX1T1, and inv(16)(p13q22)/CBFB-MYH11 have been found and used to stratify the risk. Numerous gene mutations have been implicated in the pathogenesis of AML, including mutations of DNMT3A, IDH1/2, TET2 and EZH2 in addition to RAS, KIT, NPM1, CEBPA and FLT3in the recent development of massively parallel sequencing technologies. However, even after incorporating these molecular markers, the prognosis is unclear in a subset of AML patients. Recently, NUP98-NSD1 fusion gene was identified as a poor prognostic factor for AML. We have reported that all pediatric AML patients with NUP98-NSD1 fusion showed high expression of the PR domain containing 16 (PRDM16; also known as MEL1) gene, which is a zinc finger transcription factor located near the breakpoint at 1p36. PRDM16 is highly homologous to MDS1/EVI1, which is an alternatively spliced transcript of EVI1. Furthermore, PRDM16 is essential for hematopoietic stem cell maintenance and remarkable as a candidate gene to induce leukemogenesis. Recent reports revealed that high PRDM16 expression was a significant marker to predict poor prognosis in pediatric AML. However, the significance of PRDM16 expression is unclear in adult AML patients. Methods A total of 151 adult AML patients (136 patients with de novo AML and 15 patients with relapsed AML) were analyzed. They were referred to our institution between 2004 and 2015 and our collaborating center between 1996 and 2013. The median length of follow-up for censored patients was 30.6 months. Quantitative RT-PCR analysis was performed using the 7900HT Fast Real Time PCR System with TaqMan Gene Expression Master Mix and TaqMan Gene Expression Assay. In addition to PRDM16, ABL1 was also evaluated as a control gene. We investigated the correlations between PRDM16 gene expression and other genetic alterations, such as FLT3-ITD, NPM1, and DNMT3A, and clarified the prognostic impact of PRDM16 expression in adult AML patients. Mutation analyses were performed by direct sequence analysis, Mutation Biased PCR, and the next-generation sequencer Ion PGM. Results PRDM16 overexpression was identified in 29% (44/151) of adult AML patients. High PRDM16 expression correlated with higher white blood cell counts in peripheral blood and higher blast ratio in bone marrow at diagnosis; higher coincidence of mutation in NPM1 (P = 0.003) and DNMT3A (P = 0.009); and lower coincidence of t(8;21) (P = 0.010), low-risk group (P = 0.008), and mutation in BCOR (P = 0.049). Conversely, there were no significant differences in age at diagnosis and sex distribution. Patients with high PRDM16 expression tended to be low frequency in M2 (P = 0.081) subtype, and the remaining subtype had no significant differences between high and low PRDM16 expression. Remarkably, PRDM16 overexpression patients were frequently observed in non-complete remission (55.8% vs. 26.3%, P = 0.001). Patients with high PRDM16 expression tended to have a cumulative incidence of FLT3-ITD (37% vs. 21%, P = 0.089) and MLL-PTD (15% vs. 5%, P = 0.121). We analyzed the prognosis of 139 patients who were traceable. The overall survival (OS) and median survival time (MST) of patients with high PRDM16 expression were significantly worse than those of patients with low expression (5-year OS, 17% vs. 32%; MST, 287 days vs. 673 days; P = 0.004). This trend was also significant among patients aged <65 years (5-year OS, 25% vs. 48%; MST, 361 days vs. 1565 days, P = 0.013). Moreover, high PRDM16 expression was a significant prognostic factor for FLT3-ITD negative patients aged < 65 years in the intermediate cytogenetic risk group (5-year OS, 29% vs. 58%; MST, 215 days vs. undefined; P = 0.032). Conclusions We investigated the correlations among PRDM16 expression, clinical features, and other genetic alterations to reveal clinical and prognostic significance. High PRDM16 expression was independently associated with non-CR and adverse outcomes in adult AML patients, as well as pediatric AML patients. Our finding indicated that the same pathogenesis may exist in both adult and pediatric AML patients with respect to PRDM16 expression, and measuring PRDM16 expression was a powerful tool to predict the prognosis of adult AML patients. Disclosures Inokuchi: Bristol-Myers Squibb: Honoraria, Research Funding; Novartis: Honoraria; Celgene: Honoraria; Pfizer: Honoraria.

High Response Rate in Patients with De-Novo or Relapsed/Refractory Acute Myeloid Leukemia Using a Novel Strategy of Low-Dose, Prolonged Administration of Cytarabine and Thioguanine in Combination with Filgrastim in the Ambulatory Setting: A Single-Center, Retrospective Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2624-2624
Author(s):  
Christopher K Arthur ◽  
Brandon Aubrey ◽  
Matthew Greenwood ◽  
Keith Fay ◽  
Luke Coyle ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Induction Chemotherapy ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
De Novo ◽  
Single Center ◽  
Novel Strategy ◽  
Low Dose Cytarabine ◽  
Acute Myeloid

Abstract Abstract 2624 The incidence of acute myeloid leukemia (AML) increases with age and outcomes for elderly patients remain poor. Furthermore, intensive induction chemotherapy is often unsuitable for elderly patients and can result in significant periods of inpatient care. Recent understanding of leukemia stem cell cycling suggests that prolonged cytotoxic exposure, e.g. >14–21 days, could provide a more effective anti-leukemic effect than the typical 5–7 days schedules during which time very few leukemic stem cells would be likely to undergo cell division. We have been using prolonged low-dose cytarabine schedules as reported 20 years ago (Hellstrom-Lindberg, Brit J Haem,1992;81:503), however we have combined this with oral thioguanine, a purine analogue that may synergize with cytarabine. Concomitant filgrastim or pegfilgrastim was given to minimize neutropenia and for its possible synergizing anti-leukemic effect when combined with cytotoxic agents. Encouraging experience with this schedule in a few relapsed/refractory elderly AML patients prompted us to use this strategy in elderly de-novo patients unsuitable for standard induction. Surprisingly good results prompted us to report our preliminary experience with this novel strategy. This report is a retrospective, single-center analysis of outcomes in elderly patients with AML managed as outpatients in an ambulatory care day unit. Between April 2009 and March 2011, 14 patients with either relapsed/refractory AML (n=5) or de novo AML (n=9) unsuitable for intensive therapy were treated using prolonged, low-dose cytarabine 20mg/m2/day subcutaneously and thioguanine 80mg/day orally. Treatment was given for 21 days followed by a 14 day break after which the schedule was repeated until remission. After obtaining remission, patients received a maintenance schedule consisting of 14 days on treatment with rest periods increasing from 14 to 28 days according to tolerance and time on therapy, with an intention to continue maintenance for 2 years. All patients received the treatment in an ambulatory care unit with supportive care including filgrastim or pegfilgrastim, blood and platelet transfusion as required, regular clinical review and prophylactic antibiotics and antifungal agents. Patient age ranged from 52 to 89 years (median 75y). All patients had intermediate or poor risk cytogenetics. A morphologic remission according to bone marrow aspirate was obtained in 8 patients (57.1%), with relapse seen in 1 patient at 2.6 months follow-up. Remission was maintained in 7 patients (50%) with follow-up ranging from 4.7 to 26.6 months (median 9.7 months), including 1 patient who was refractory to standard first and second-line induction chemotherapy. Refractoriness to treatment occurred in 5 patients (35.7%). Mortality relating to disease progression occurred in 3 patients (21.4%) and 1 patient died secondary to infection. All patients developed grade 3/4 neutropenia and thrombocytopenia but severe mucositis was not seen. The infection rate was low and hospital admission was uncommon. Nausea was common but manageable and significant liver toxicity was not observed. This study demonstrates that effective management of AML in elderly patients can be achieved in the outpatient setting. The data suggests a surprising efficacy for this strategy, with a remission rate comparable to that reported using standard induction chemotherapy but with a potentially favorable toxicity profile. A prospective study is now underway to further evaluate this protocol. Disclosures: Arthur: AMGEN: Honoraria.

Early Mortality In Hyperleukocytosis In Patients With Acute Myeloid Leukemia: A Systematic Review and Meta-Analysis

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2647-2647 ◽  
Author(s):  
Sapna Oberoi ◽  
Thomas Lehrnbecher ◽  
Robert Phillips ◽  
Johann K. Hitzler ◽  
Marie-Chantal Ethier ◽  
...  
Keyword(s):  
Death Rate ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Meta Analysis ◽  
Early Death ◽  
Early Mortality ◽  
Confounding Bias ◽  
Meta Regression ◽  
Low Dose Chemotherapy ◽  
Acute Myeloid

Abstract Background Hyperleukocytosis in acute myeloid leukemia (AML) is associated with early deaths, typically related to respiratory failure and intracranial ischemia/hemorrhage. Various interventions for leukoreduction including leukapheresis, low-dose chemotherapy and hydroxyurea have been used in an attempt to decrease mortality. However, there are no randomized trials and observational trials are biased. We undertook a systematic review and meta-analysis to evaluate the effect of these interventions using an “intent-to-treat” approach and classifying studies as always, sometimes and never using these interventions. Objectives The primary objective was to describe the proportion of early deaths in patients with AML with an initial WBC ≥ 100,000x109/L stratified by the approach to leukapheresis and hydroxyurea/low dose chemotherapy (universal, sometimes or never). The secondary objective was to compare the proportion of early deaths in patients who did and did not receive leukapheresis. Methods Electronic searches of Ovid Medline from 1980 to July 12, 2013, EMBASE from 1980 to July 12, 2013 and Cochrane Central Register of Controlled Trials until June 2013 were conducted. Studies were included if: (1) Population included patients with AML; and (2) Either described the proportion of patients with early deaths in patients with an initial WBC ≥ 100,000x109/L or compared the proportion of early deaths by receipt of leukapheresis in patients using the same initial WBC threshold. Studies including solely acute promyelocytic leukemia (APML) patients were excluded. The pre-specified subgroups in the evaluation of early death proportions were whether leukapheresis and low-dose chemotherapy/hydroxyurea were intended to be applied universally, sometimes or never in hyperleukocytosis. These subgroups were defined based on the study’s stated policy independent of the number of patients actually receiving the intervention. Two investigators assessed the quality of the included studies for selection and confounding bias using the Hayden framework. Synthesis of proportions was conducted using RevMan. Meta-regression was conducted in which the natural log of the proportion of early deaths was modelled. Heterogeneity was assessed by visual inspection and I2. Results Twenty studies representing 1427 patients were included in the final meta-analysis. Overall, the proportion of early deaths (19 studies, 1281 patients) was 19.9% (95% CI: 14.7-25.1). Table 1 illustrates that neither leukapheresis strategy nor hydroxyurea/low dose chemotherapy influenced the early death rate. Meta-regression evaluating the percent of patients receiving leukapheresis showed no relationship with early death rate (odds ratio 1.01, 95% CI: 0.99-1.02; P=0.249). Evaluation of leukapheresis within studies included 7 studies of which 6 were at high risk of confounding bias and sufficiently heterogeneous to not permit synthesis. Conclusion Early mortality related to hyperleukocytosis is high and is not influenced by universal or selected use of leukapheresis or low-dose chemotherapy/hydroxyurea. This meta-analysis does not support these interventions for patients with AML and hyperleukocytosis. Novel approaches are required to decrease mortality. Disclosures: Lehrnbecher: Gilead: Honoraria; MSD: Honoraria; Pfizer: Honoraria; Astellas: Honoraria.

High BMP2 Expression Is a Poor Prognostic Factor and a Good Candidate to Identify CBFA2T3-GLIS2-like High-Risk Subgroup in Pediatric Acute Myeloid Leukemia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2583-2583 ◽  
Author(s):  
Yusuke Hara ◽  
Genki Yamato ◽  
Norio Shiba ◽  
Kentaro Ohki ◽  
Myoung-Ja Park ◽  
...  
Keyword(s):  
High Risk ◽  
Myeloid Leukemia ◽  
Gene Mutations ◽  
Fusion Genes ◽  
Gene Expressions ◽  
Poor Prognostic Factor ◽  
Pediatric Acute Myeloid Leukemia ◽  
Expression Levels ◽  
Pediatric Aml ◽  
Induction Failure

Abstract <Background> Recent molecular analyses have identified novel inv(16)(p13.3q24.3)/CBFA2T3-GLIS2 in 13-27% of pediatric acute megakaryoblastic leukemia with non-Down syndrome. Some previous studies reported a poor prognosis of CBFA2T3-GLIS2, and one of them reported that all CBFA2T3-GLIS2-positive patients had high BMP2 expression. BMP2 belongs to the TGF-β family and plays essential roles in the regulation of cell proliferation, differentiation, and motility. Besides, new information about the relationship of BMP2 with oncogenesis has been determined in some cancers. Thus, we examined molecular and clinical significance of high BMP2 expression in pediatric acute myeloid leukemia (AML) to identify whether high BMP2 expression was useful for the detection of "CBFA2T3-GLIS2-like" high-risk subgroup. <Patients and Methods> We analyzed 369 cDNA samples of de novo pediatric AML patients who enrolled in the AML-05 study conducted by Japanese Pediatric Leukemia/Lymphoma Study Group. We examined fusion genes of CBFA2T3-GLIS2, NUP98-JARID1A, RBM15-MKL1, MLL-MLLT3, MLL-MLLT10, NUP98-NSD1, FUS-ERG, DEK-NUP214, RUNX1-RUNX1T1, and CBFB-MYH11, gene mutations of KIT, NRAS, KRAS, WT1, NPM1, MLL-PTD, and FLT3-ITD, and gene expressions of BMP2, PRDM16, and EVI1. Fusion genes and gene mutations were analyzed by PCR and/or RT-PCR, and gene expressions by realtime quantitative PCR. These expression levels were calculated relative to ABL1 expression, and high expression of each gene was defined by ROC analysis. <Results> CBFA2T3-GLIS2 gene fusions were identified in 11 patients (3.0%), all of whom were diagnosed as FAB-M7. Their 4-year overall survival probability (4-pOS) and event-free survival probability (4-pEFS) were significantly poorer than those of CBFA2T3-GLIS2-negative patients (36.4% vs 67.9%, p = 0.003, and 9.1% vs 53.7%, p < 0.001, respectively). Besides, 18 patients (4.9%), including 7 CBFA2T3-GLIS2-positive patients, exhibited high BMP2 expression (BMP2/ABL1 ratio ≥ 1.12). BMP2 expression levels of CBFA2T3-GLIS2-positive patients(range 0.494-3.608, median 1.274) were significantly higher than those of CBFA2T3-GLIS2-negative patients (range 0-3.653, median 0.044) (p < 0.001). Notably, 4-pOS and 4-pEFS of the patients with high BMP2 expression were significantly much lower than those of the patients with low BMP2 expression (25.0% vs 69.3%, p < 0.001, and 16.7% vs 54.3%, p < 0.001, respectively). Age at diagnosis of the patients with high BMP2 expression was significantly lower than that of the patients with low BMP2 expression (median, 2.3 vs 8.3 years, p = 0.047), whereas WBC count was not significantly different between 2 groups (median, 40,850 vs 19,700/µl, p = 0.113). FAB classifications of the patients with high BMP2 expression were as follows: M1 (n = 1), M2 (n = 3), M5a (n = 4), M7 (n = 8), and RAEB-T (n = 2). Cytogenetic and molecular analyses of the patients with high BMP2 expression revealed the presence of CBFA2T3-GLIS2 (n = 7), FUS-ERG (n = 3), MLL-rearrangements (n = 2), RUNX1-RUNX1T1 (n = 1), inv(3)(q21q26.2) (n = 1), t(8;16)(p11.2;p13.3) (n = 1), monosomy 7 (n = 2), NRAS (n = 3), KRAS (n = 1), KIT (n = 1), FLT3-ITD (n = 1), high PRDM16 expression (n = 3), and high EVI1 expression (n = 2). Even if we exclude patients with RUNX1-RUNX1T1 (n = 106) and CBFB-MYH11 (n = 31) from all 369 patients (a total of 232 patients), 4-pOS and pEFS of the patients wtih high BMP2 expression (n = 17, one RUNX1-RUNX1T1-positive patient was excluded) were significantly lower than those of the patients with low BMP2 expression (20.2% vs 56.8%, p < 0.001, and 17.6% vs 45.1%, p = 0.002, respectively). As for the risk stratification, one, 9, and 4 patients were classified into low, intermediate, and high-risk group, respectively, and 4 patients had induction failure. Concerning CBFA2T3-GLIS2-positive patients, all of 3 patients with induction failure had high BMP2 expression, and 5 of 7 patients with high BMP2 expression died, whereas 2 of 4 patients with low BMP2 expression died. <Conclusions> High BMP2 expression was considered as a poor prognostic factor in pediatric AML. When compared with CBFA2T3-GLIS2-negative patients, BMP2 expression levels of CBFA2T3-GLIS2 -positive patients were extremely high, indicating that high BMP2 expression might be a good candidate to identify high-risk CBFA2T3-GLIS2-like patients. Therefore, investigation of BMP2 inhibitors for these patients will be expected. Disclosures No relevant conflicts of interest to declare.

Leukapheresis and low-dose chemotherapy do not reduce early mortality in acute myeloid leukemia hyperleukocytosis: A systematic review and meta-analysis

2014 ◽  
Vol 38 (4) ◽  
pp. 460-468 ◽  
Author(s):  
Sapna Oberoi ◽  
Thomas Lehrnbecher ◽  
Bob Phillips ◽  
Johann Hitzler ◽  
Marie-Chantal Ethier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Meta Analysis ◽  
Early Mortality ◽  
Low Dose Chemotherapy ◽  
Acute Myeloid
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