Improving outcomes for patients with acute myeloid leukemia in first relapse: A single center experience

被引:39
作者
Pemmaraju, Naveen [1 ]
Kantarjian, Hagop [1 ]
Garcia-Manero, Guillermo [1 ]
Pierce, Sherry [1 ]
Cardenas-Turanzas, Marylou [1 ]
Cortes, Jorge [1 ]
Ravandi, Farhad [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Leukemia, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
ACUTE MYELOGENOUS LEUKEMIA; RISK MYELODYSPLASTIC SYNDROMES; CONVENTIONAL CARE REGIMENS; SALVAGE THERAPY; ADULT PATIENTS; PHASE-III; SURVIVAL; DECITABINE; INHIBITORS; CHEMOTHERAPY;
D O I
10.1002/ajh.23858
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The outcome of patients with relapsed acute myeloid leukemia (AML) remains unsatisfactory, with few available effective therapies. Increased understanding of the biology of the disease has led to the identification of novel therapeutic agents, several of which have been evaluated in recently conducted clinical trials. We sought to determine whether the introduction of these agents as well as modern supportive care measures has already translated to better outcomes. We examined the outcomes of 1,056 patients with AML in first relapse treated between January 1993 and December 2013 at our institution. As previously reported, the independent prognostic factors for survival after first relapse included age at relapse, cytogenetics, and duration of first complete remission. Upon multivariable analysis, treatment era was an independent predictor of survival, with significant improvement in overall survival between 2008 and 2013 as compared to prior time periods. Modern supportive care measures as well as participation in clinical trials of novel agents are already improving the outcomes in first relapse. (C) 2014 Wiley Periodicals, Inc.
引用
收藏
页码:27 / 30
页数:4
相关论文
共 20 条
[1]   Phase I study of decitabine alone or in combination with valproic acid in acute myeloid leukemia [J].
Blum, William ;
Klisovic, Rebecca B. ;
Hackanson, Bjoern ;
Liu, Zhongfa ;
Liu, Shujun ;
Devine, Hollie ;
Vukosavljevic, Tamara ;
Huynh, Lenguyen ;
Lozanski, Gerard ;
Kefauver, Cheryl ;
Plass, Christoph ;
Devine, Steven M. ;
Heerema, Nyla A. ;
Murgo, Anthony ;
Chan, Kenneth K. ;
Grever, Michael R. ;
Byrd, John C. ;
Marcucci, Guido .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (25) :3884-3891
[2]   Clinical response and miR-29b predictive significance in older AML patients treated with a 10-day schedule of decitabine [J].
Blum, William ;
Garzon, Ramiro ;
Klisovic, Rebecca B. ;
Schwind, Sebastian ;
Walker, Alison ;
Geyer, Susan ;
Liu, Shujun ;
Havelange, Violaine ;
Becker, Heiko ;
Schaaf, Larry ;
Mickle, Jon ;
Devine, Hollie ;
Kefauver, Cheryl ;
Devine, Steven M. ;
Chan, Kenneth K. ;
Heerema, Nyla A. ;
Bloomfield, Clara D. ;
Grever, Michael R. ;
Byrd, John C. ;
Villalona-Calero, Miguel ;
Croce, Carlo M. ;
Marcucci, Guido .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2010, 107 (16) :7473-7478
[3]   Prognostic index for adult patients with acute myeloid leukemia in first relapse [J].
Breems, DA ;
Van Putten, WLJ ;
Huijgens, PC ;
Ossenkoppele, GJ ;
Verhoef, GEG ;
Verdonck, LF ;
Vellenga, E ;
De Greef, G ;
Jacky, E ;
Van der Lelie, J ;
Boogaerts, MA ;
Löwenberg, B .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (09) :1969-1978
[4]   Therapeutic Advances in Acute Myeloid Leukemia [J].
Burnett, Alan ;
Wetzler, Meir ;
Loewenberg, Bob .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (05) :487-494
[5]   A stratification system for evaluating and selecting therapies in patients with relapsed or primary refractory acute myelogenous leukemia [J].
Estey, E ;
Kornblau, S ;
Pierce, S ;
Kantarjian, H ;
Beran, M ;
Keating, M .
BLOOD, 1996, 88 (02) :756-756
[6]   Treatment of relapsed and refractory acute myelogenous leukemia [J].
Estey, EH .
LEUKEMIA, 2000, 14 (03) :476-479
[7]   Prolonged survival with improved tolerability in higher-risk myelodysplastic syndromes: azacitidine compared with low dose ara-C [J].
Fenaux, Pierre ;
Gattermann, Norbert ;
Seymour, John F. ;
Hellstroem-Lindberg, Eva ;
Mufti, Ghulam J. ;
Duehrsen, Ulrich ;
Gore, Steven D. ;
Ramos, Fernando ;
Beyne-Rauzy, Odile ;
List, Alan ;
McKenzie, David ;
Backstrom, Jay ;
Beach, Charles L. .
BRITISH JOURNAL OF HAEMATOLOGY, 2010, 149 (02) :244-249
[8]   Azacitidine Prolongs Overall Survival Compared With Conventional Care Regimens in Elderly Patients With Low Bone Marrow Blast Count Acute Myeloid Leukemia [J].
Fenaux, Pierre ;
Mufti, Ghulam J. ;
Hellstrom-Lindberg, Eva ;
Santini, Valeria ;
Gattermann, Norbert ;
Germing, Ulrich ;
Sanz, Guillermo ;
List, Alan F. ;
Gore, Steven ;
Seymour, John F. ;
Dombret, Herve ;
Backstrom, Jay ;
Zimmerman, Linda ;
McKenzie, David ;
Beach, C. L. ;
Silverman, Lewis R. .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (04) :562-569
[9]   Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study [J].
Fenaux, Pierre ;
Mufti, Ghulam J. ;
Hellstrom-Lindberg, Eva ;
Santini, Valeria ;
Finelli, Carlo ;
Giagounidis, Aristoteles ;
Schoch, Robert ;
Gattermann, Norbert ;
Sanz, Guillermo ;
List, Alan ;
Gore, Steven D. ;
Seymour, John F. ;
Bennett, John M. ;
Byrd, John ;
Backstrom, Jay ;
Zimmerman, Linda ;
McKenzie, David ;
Beach, C. L. ;
Silverman, Lewis R. .
LANCET ONCOLOGY, 2009, 10 (03) :223-232
[10]   Decitabine improves patient outcomes in myelodysplastic syndromes - Resuits of a Phase III randomized study [J].
Kantarjian, H ;
Issa, JPJ ;
Rosenfeld, CS ;
Bennett, JM ;
Albitar, M ;
DiPersio, J ;
Klimek, V ;
Slack, J ;
de Castro, C ;
Ravandi, F ;
Helmer, R ;
Shen, LL ;
Nimer, SD ;
Leavitt, R ;
Raza, A ;
Saba, H .
CANCER, 2006, 106 (08) :1794-1803