Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8453331 | Leukemia Research | 2018 | 7 Pages |
Abstract
We evaluated outcomes of 100 patients with high risk AML treated with Ida-FLAG induction as first-line therapy. 72 achieved remission with one cycle; 19 did not. High risk cytogenetics and TP53 mutations were associated with failure to achieve remission. In those reaching remission, allogeneic bone marrow transplantation was associated with better relapse-free and overall survival. Those not achieving remission with induction therapy were extremely unlikely to reach remission with further therapy and had a dismal prognosis. Exploratory molecular analysis confirmed persistence of the dominant genetic mutations identified at diagnosis. Ex vivo chemosensitivity did not demonstrate significant differences between responders and non-responders. Thus, Ida-FLAG induction has a high chance of inducing remission in patients with high risk AML. Those achieving remission require allogeneic transplantation to achieve cure; those not achieving remission rarely respond to salvage chemotherapy and have a dismal outcome. Alternatives to conventional chemotherapy must be considered in this group.
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Authors
Simon Kavanagh, Emily Heath, Rose Hurren, Marcela Gronda, Samir H. Barghout, Sanduni U. Liyanage, Thirushi P. Siriwardena, Jaime Claudio, Tong Zhang, Mahadeo Sukhai, Tracy L. Stockley, Suzanne Kamel-Reid, Amr Rostom, Andrzej Lutynski, Dina Khalaf,