With contemporary treatment, 80% to 90% of children with acute
|
|
- Cuthbert Neal
- 5 years ago
- Views:
Transcription
1 157 Prognostic Factors and Outcome of Recurrence in Childhood Acute Myeloid Leukemia Jeffrey E. Rubnitz, MD, PhD 1,2 Bassem I. Razzouk, MD 1,2 Shelly Lensing, MS 3 Stanley Pounds, PhD 3 Ching-Hon Pui, MD 1,2,4 Raul C. Ribeiro, MD 1,2 1 Department of Oncology, St. Jude Children s Research Hospital, Memphis, Tennessee. 2 Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee. 3 Department of Biostatistics, St. Jude Children s Research Hospital, Memphis, Tennessee. 4 Department of Pathology, St. Jude Children s Research Hospital, Memphis, Tennessee. BACKGROUND. Outcome after recurrence of childhood acute myeloid leukemia (AML) is poor. We performed this study to identify prognostic factors for recurrence and for survival after recurrence of AML. METHODS. The clinical characteristics, biological features, treatment modalities, and outcomes of children with de novo AML who were enrolled on 3 consecutive clinical protocols from 1987 to 2002 at St. Jude Children s Research Hospital were studied. Regression modeling was used to identify prognostic factors for recurrence and for survival after recurrence. RESULTS. The outcome after recurrence was poor, with a 5-year survival estimate of only 23.3% 6 5.7%. Multivariable analysis indicated that male sex (P ¼.005), autologous stem cell transplant before recurrence (P ¼.097), each additional month from diagnosis to recurrence (P ¼.041), and stem cell transplant after recurrence (P <.001) were associated with a better survival after recurrence, whereas M5 or M7 morphology (P ¼.001) were significantly predictive of a lower survival estimate after recurrence. CONCLUSION. Survival after recurrence was poor in children with AML. Novel therapies are urgently needed to prevent or to treat recurring AML. Cancer 2007;109: Ó 2006 American Cancer Society. Supported in part by Cancer Center Support (Core) grant P30 CA from the National Institutes of Health by a Center of Excellence Grant from the State of Tennessee, and by the American Lebanese Syrian Associated Charities (ALSAC). C.-H. Pui is an American Cancer Society Professor. Presented, in part, at the Annual Meeting of the American Society of Hematology, December 12, 2005, Atlanta, GA. We thank Sharon Naron for expert editorial review and Ramona Ratliff for assistance with data collection. Address for reprints: Jeffrey E. Rubnitz, MD, PhD, Department of Oncology, Mail Stop 260, St. Jude Children s Research Hospital, 332 N. Lauderdale St., Memphis, TN ; Fax: (901) ; jeffrey.rubnitz@stjude.org Received September 6, 2006; revision received October 9, 2006; accepted October 11, KEYWORDS: acute myeloid leukemia, recurrence, childhood. With contemporary treatment, 80% to 90% of children with acute myeloid leukemia (AML) experience complete remission (CR), but 30% to 40% of these patients subsequently suffer recurrence, and the long-term survival rate is only about 50%. 1 7 After recurrence, the likelihood of survival is poor, ranging from 21% to 33% in recent reports In these reports the length of first remission was the best predictor of survival It is not clear whether other factors are prognostically important after recurrence. We reviewed the outcome of all patients treated on successive AML clinical trials at our institution from 1987 to 2002 to investigate factors predictive of hematologic recurrence, second remission, or overall survival (OS) after recurrence. MATERIALS AND METHODS Patients From 1987 through 2002, 191 patients with de novo AML who were 21 years of age or younger (excluding those with Down syndrome or acute promyelocytic leukemia) were enrolled on 3 successive institutional clinical trials (AML-87, AML-91, and AML-97). 6 The median time since last follow-up for surviving patients was 0.6 years (range, years) at the time of this study, and 72.9% had received follow-up during the past year. Of the 160 patients who attained CR, 60 suffered hematologic ª 2006 American Cancer Society DOI /cncr Published online 28 November 2006 in Wiley InterScience (
2 158 CANCER January 1, 2007 / Volume 109 / Number 1 TABLE 1 Univariate Analysis of Factors Prognostic of Event-Free Survival (EFS) Characteristics at diagnosis n Percentage 5-y EFS 6 SE P* Sex Male Female Age, y 0-< Race White Black Other Leukocyte count < /L /L Platelet count < /L /L FAB M M M M M Other y Cytogenetics t(9,11) <.001 inv(16) t(8;21) Other 11q23/MLL Other Study AML AML AML SE indicates standard error; FAB, French-American-British; AML, acute myeloid leukemia. * Exact log-rank test. y M0, M6, and unclassifiable. or combined recurrences and are the subject of this report. Patients with isolated extramedullary recurrence were not included in analyses of outcome after recurrence. Written informed consent was obtained from the legal guardians or patients (as appropriate), and all studies (therapeutic and diagnostic) were approved by our Institutional Review Board. Diagnoses were based on standard techniques and cases were classified by morphologic, immunologic, and genetic testing. TABLE 2 Multivariable Analysis of Factors Prognostic of Event-Free Survival Variable* Hazard ratio y 95% Confidence limits Age 10 years Leukocyte count /L FAB M <.001 Favorable karyotype { AML87 protocol AML91 protocol FAB indicates French-American-British; AML, acute myeloid leukemia. * Reference categories age <10 years, leukocyte count < /L, all other FAB categories combined for M7 FAB, all other categories combined for favorable karyotype, and AML97 protocol. y A hazard ratio greater than 1 is unfavorable, indicating increased risk of recurrence or death. { Favorable karyotype includes t(9;11) and inv(16). Statistical Methods The method of Kaplan and Meier 13 was used to estimate the probability of event-free survival (EFS) and to estimate the probability of survival of patients after recurrence. Standard errors were calculated by the method of Peto et al. 14 The duration of EFS was calculated from the on-study date to the date of recurrence or death from any cause. The EFS was recorded as 0 for patients who did not achieve a CR and was censored at the date of last follow-up for those who were alive and in remission. The duration of postrecurrence OS was calculated from the date of recurrence to the date of death and was censored at the date of last follow-up for surviving patients. Various potential prognostic factors were compared by using exact log-rank analyses. The independent effect of prognostic variables was investigated by using proportional hazards modeling. 15 Age, hemoglobin concentration, platelet count, and leukocyte count were investigated as continuous and categorical variables in separate models. Given the number of variables under consideration, stepwise variable selection was performed using SAS Release 9.1 software (SAS Institute, Cary, NC) to select variables included in the models. For variable selection, the variable entry and removal significance levels were To identify prognostic factors for a second remission, exact x 2 tests were used for univariate comparisons. Logistic regression modeling was then used to explore joint effects with stepwise variable selection similar to that described above. The final model was fitted using exact logistic modeling methods as implemented in SAS Release 9.1. P-values <.05 were considered to indicate a statistically significant association, and all P-values were 2-sided. No adjustment was made for multiple comparisons. RESULTS Response to Initial Therapy The characteristics of the 191 patients are shown in Table 1. Overall, 160 (84%) patients attained CR and the 5-year EFS estimate (6SE) was 41.8% 6 3.9%. In P
3 Outcome After Recurrence of Childhood AML/Rubnitz et al. 159 TABLE 3 Univariate Analysis of Factors Prognostic of Second Remission and Survival After Recurrence Characteristics at diagnosis and treatment No. No second remission N ¼ 21 No. (%) Second remission N ¼ 39 No. (%) P* Percentage 5-y OS 6 SE P y Sex Male 30 5 (16.7) 25 (83.3) Female (53.3) 14 (46.7) Age, y 0-< (35.1) 24 (64.9) (34.8) 15 (65.2) Race White (31.6) 26 (68.4) Black 14 6 (42.9) 8 (57.1) Other 8 3 (37.5) 5 (62.5) Leukocyte count, 10 9 /L < (39.0) 25 (61.0) (26.3) 14 (73.7) Platelets, 10 9 /L < (27.3) 16 (72.7) (39.5) 23 (60.5) Hgb, 10 9 /L < (38.9) 11 (61.1) (28.1) 23 (71.9) > (55.6) 4 (44.4) CNS status CNS3, 5 WBC/mL with blasts 7 2 (28.6) 5 (71.4) CNS2, <5 WBC/mL with blasts 12 5 (41.7) 7 (58.3) CNS1, no blasts (38.7) 19 (61.3) Traumatic 8 2 (25.0) 6 (75.0) FAB subtype M (10.0) 9 (90.0).045 { { M (34.6) 17 (65.4) M4 8 2 (25.0) 6 (75.0) M5 9 4 (44.4) 5 (55.6) M7 6 5 (83.3) 1 (16.7) 0 Other { 1 0 (0.0) 1 (100.0) Cytogenetic features t(9,11) or inv(16) 3 1 (33.3) 2 (66.6) t(8;12) 19 5 (26.3) 14 (73.7) Other 11q23/MLL 11 4 (36.4) 7 (63.6) Other (40.7) 16 (59.3) Study AML (26.7) 11 (73.3) AML (36.4) 14 (63.6) AML (39.1) 14 (60.9) Treatment prior to recurrence Chemotherapy only 31 8 (25.8) 23 (74.2) Autotransplant 20 6 (30.0) 14 (70.0) Allotransplant 9 7 (77.8) 2 (22.2) 0 Treatment after relapse Palliative/none 4 0 <.001 Chemotherapy 17 0 Transplant Time from diagnosis to recurrence Recurrence <1 y (43.2) 21 (56.8) Recurrence 1y 23 5(21.7) 18(78.3) OS indicates overall survival; SE, standard error; CNS, central nervous system; WBC, white blood cell count; FAB, French-American-British; AML, acute myeloid leukemia. * Exact x 2 test. y Exact log-rank test. { Other category is 1 M0 patient, who was not included in the calculation of P. This patient was alive at 12.6 years after recurrence.
4 160 CANCER January 1, 2007 / Volume 109 / Number 1 TABLE 4 Multivariable Analysis of Factors Prognostic of Second Remission and Survival After Recurrence Second remission variables* Odds ratio y 95% Confidence limits P Male M Allogeneic transplant before relapse Overall Survival Variables { Hazard Ratio y 95% Confidence Limits P Male FAB M5 or M Autologous transplant before relapse Transplant after relapse <.001 Months to relapse from diagnosis FAB indicates French-American-British. * Reference categories are female, all other FAB categories combined for M1 FAB, chemotherapy only or autologous transplant for therapy prior to relapse. y An odds ratio greater than 1 is favorable, indicating increased odds of achieving second remission. A hazard ratio greater than 1 is unfavorable, indicating increased risk of death. { Reference categories are female, all other FAB categories combined for M5 and M7 FAB group, chemotherapy only and allogeneic transplant for therapy prior to relapse, and palliative care/none or chemotherapy only for therapy after recurrence. For months to recurrence from diagnosis, every month from diagnosis conveyed a 3% (95% CI, 0.1 6%) reduction in the risk of death. univariate analysis, age, French-American-British (FAB) subtype, and karyotype were predictive of outcome (Table 1). Proportional hazards modeling (Table 2) demonstrated that leukocyte count /L at diagnosis (5-year EFS 6 SE, 34.7% 6 7.2%), FAB M7 subtype (5- year EFS 6 SE, 20.8% 6 9.3%), and age older than 10 years (5-year EFS 6 SE, 32.4% 6 5.8%) each conferred an increased risk of recurrence or death, whereas a favorable karyotype (5-year EFS 6 SE, 71.1% 6 8.0%) conferred a decreased risk that was statistically significant after adjustment for other variables. For the purposes of this study, favorable karyotype was defined as t(9;11) or inv(16) based on the excellent outcomes for patients with either of these characteristics (Table 1). Outcome After Recurrence Of the 160 patients who attained a CR, 60 suffered hematologic recurrences at a median of 9.8 months (range, months) after diagnosis. Thirty-seven (62%) patients had a recurrence younger than 1 year after diagnosis and 23 (38%) experienced recurrence later. After recurrence, 4 patients received palliative care, 17 received chemotherapy alone, and 39 underwent hematopoietic stem cell transplant (HSCT). The 17 patients who received only chemotherapy did not undergo stem cell transplant because of a lack of a suitable donor or because of progressive disease before FIGURE 1. Survival after recurrence according to treatment before recurrence. The 5-year survival estimates (6standard error [SE]) were 45% 6 11% for patients who had recurrence after undergoing autologous stem cell transplantation in first remission, 16% 6 7% for patients who had recurrence after receiving only chemotherapy, and 0% for patients who received allogeneic stem cell transplantation in first remission. transplantation could be performed. To prevent any bias that might be introduced by removing the 4 patients who received only palliative care, most of whom had very aggressive disease after recurrence, all analyses described below included these patients. Notably, these results were similar to those of separate analyses that excluded these patients (data not shown). Thirty-nine (65%) of the patients attained a second remission. At the time of last follow-up, 14 patients were alive, 30 died of progressive disease, and 16 died of regimen-related toxicity (14 after stem cell transplant). The 5-year OS estimate 6 SE after recurrence for the entire cohort of 60 patients was 23.3% 6 5.7%. In a univariate analysis (Table 3), factors associated with attainment of second remission were sex (males, 83%; females, 47%; P ¼.006),thetypeofinitialtherapy (chemotherapy alone, 74%; autologous transplant, 70%; allogeneic stem cell transplant, 22%; P ¼.012), and FAB subtype (eg, FAB M7, 17%). Logistic regression analysis (Table 4) demonstrated that male sex (P ¼.005) and M1 subtype (P ¼.056) were associated with attainment of CR2, whereas allogeneic stem cell transplant during first remission (P ¼.023) was associated with failure to achieve second remission. Univariate analysis of survival after recurrence indicated significant differences according to sex (P ¼.002), type of treatment before recurrence (P ¼.020, Fig. 1), and type of treatment after recurrence (P<.001, Table 3). There was a trend toward improved survival among patients who had a recurrence older than 1 year from diagnosis as compared with those who had recurrence earlier(5-yearos6 SE, 26.1% 6 8.5% vs 21.6% 6 7.2%,
5 Outcome After Recurrence of Childhood AML/Rubnitz et al. 161 P ¼.112). There were no survivors after recurrence among patients with M7 AML or patients who underwent allogeneic stem cell transplant in first remission. Relatively good outcomes after recurrence were observed among patients who received autologous transplant during first remission (5-year OS 6 SE, 45.0% %) and among patients who underwent stem cell transplant after recurrence (5-year OS 6 SE, 35.9% 6 8.0%). In a multivariable Cox regression model (Table 4), M5 or M7 morphology (P ¼.001) was associated with a lower survival estimate after recurrence. In contrast, male sex (P ¼.005), autologous HSCT before recurrence (P ¼.097), HSCT after recurrence (P <.001), and each additional month from diagnosis to recurrence (P ¼.041) were significantly predictive of improved survival. Among the 14 patients who had experienced recurrence and who survived at the time of this report, all but 2 had significant late effects of therapy. Nine patients have endocrine disorders, including growth hormone deficiency in 6, gonadal dysfunction in 2, and hypothyroidism in 7. Two patients have seizures or encephalopathy, 4 patients have cataracts, 4 have school difficulties, 3 have chronic renal insufficiency, and 1 has hepatitis C. DISCUSSION We previously demonstrated that among patients with AML treated at St. Jude, the t(9;11) conferred a favorable outcome, 16 the t(8;21), an intermediate outcome, 17 and M7 morphology, a dismal outcome. 18 Inv(16) was associated with a good prognosis only during the recent era. 19 In the present study we sought to update and expand our analysis of prognostic factors for recurrence and to identify factors predictive of outcome after recurrence. In this study, better outcomes were observed among patients younger than 10 years old and among patients with the t(9;11) or inv(16), whereas an initial leukocyte count greater than /L, M7 morphology, and treatment on an earlier protocol were associated with a greater risk of recurrence. After recurrence, about two-thirds of patients achieved a second remission. Patients with M7 AML and patients who underwent allogeneic stem cell transplant during first remission had particularly low second remission rates of only 17% and 22%, respectively. Overall, 23% of patients who had recurrence are long-term survivors, similar to recent reports In concordance with their low rates of second remission, patients with M7 AML and patients who underwent allogeneic stem cell transplant during first remission had dismal outcomes after recurrence. Although survival estimates were statistically better in certain subgroups, including males, patients who had late recurrences, and patients who underwent stem cell transplant after recurrence, outcomes were clinically unsatisfactory in all groups. For example, only 45% of patients who underwent allogeneic stem cell transplant after recurrence are longterm survivors. In addition, serious late effects were observed in the majority of survivors. What is the likelihood of survival after recurrence in AML? Investigators in the Berlin-Frankfurt-Munster (BFM) study group reported a 51% second remission rate and a 5-year survival estimate of 21% for children with AML after first recurrence. 9 In that report, patients whose recurrence occurred less than 1.5 years after diagnosis had a 5-year survival estimate of only 10%, compared with 40% for those whose recurrence occurred later. In a report from the Children s Cancer Group, the survival after bone marrow recurrence was 21% overall and only 8% in patients who had recurrence less than 1 year from diagnosis. 12 Similarly, the 3-year survival estimate after recurrence was 24% for children treated on the Medical Research Council AML10 trial but was only 11% for children whose initial remission lasted less than 1 year. 8 Children whose recurrences occurred later fared significantly better, with a 3-year survival estimate of 49%. Recently, the Leucamie Aique Myeloide Enfant study group reported a 5-year survival estimate of 33% and confirmed the prognostic impact of time to recurrence. 10 Survival rates were 24% for children whose first remission lasted less than 12 months and 54% for children with longer first remissions. The heterogeneity of our patient population, the retrospective nature of our study, and the variety of chemotherapy regimens used over a 15-year period preclude our assessment of the efficacy of any 1 treatment regimen. Many of the patients in the present study received cladribine alone 20,21 or in combination with cytarabine 22 or topotecan. Despite the activity of cladribine against recurring AML, 21 the combination of cladribine and cytarabine was ineffective at inducing second complete remission in a Phase II study. 22 The use of this regimen may have contributed to our low second remission rate. On the basis of these results, our current treatment strategies for recurring AML no longer include cladribine. In contrast, the Children s Cancer Group reported a 76% second remission rate for patients with refractory or recurring AML who were treated with mitoxantrone and cytarabine. 11 However, even with the excellent second remission rate, the 2- year survival estimate was only 24%. 11 In the present study, as well as in previous studies, 8 11 second recurrence and progressive disease were the main causes of treatment failure and death, but regimen-related toxicity after recurrence was a significant problem. Support-
6 162 CANCER January 1, 2007 / Volume 109 / Number 1 ive care measures currently in place at our institution, including the use of prophylactic antibiotics and prophylactic voriconazole in all patients with AML, have reduced complications related to infection in newly diagnosed patients with AML. We hope that this finding will extend to recurring AML as well. In the present study, even patients who underwent allogeneic stem cell transplant after recurrence had an unsatisfactory outcome. Most patients underwent transplantation from a matched sibling or matched unrelated donor, as we were not routinely performing haploidentical stem cell transplants during the time period of this retrospective study. Less than half of patients who underwent transplant survived, and most of the survivors had significant late effects. Because of the small numbers of patients and because of changes in conditioning regimens during this study, we cannot comment on differences in graft versus leukemia effects between matchedsiblingandmatchedunrelateddonortransplants. Nevertheless, it seems unlikely that further progress can be made by using conventional chemotherapy or stem cell transplantation alone. Therapies under development include proteasome inhibitors, 23,24 histone deacetylase inhibitors, 25,26 and agents that target leukemia-specific abnormalities, such as constitutively activated tyrosine kinases Recently, cellular therapy with haploidentical natural killer cells has also been shown to exert antitumor activity with minimal toxicity in patients with recurrence AML. 30 We are currently testing the tandem application of haploidentical stem cell transplantation followed by natural killer cell transplantation for patients with high-risk leukemia. Clearly, novel therapies are urgently needed, both to prevent recurrence and to treat patients with recurring AML. REFERENCES 1. Liang DC, Chang TT, Lin KH, et al. Improved treatment results for childhood acute myeloid leukemia in Taiwan. Leukemia. 2006;20: Creutzig U, Zimmermann M, Ritter J, et al. Treatment strategies and long-term results in paediatric patients treated in four consecutive AML-BFM trials. Leukemia. 2005;19: Smith FO, Alonzo TA, Gerbing RB, Woods WG, Arceci RJ. Long-term results of children with acute myeloid leukemia: a report of three consecutive Phase III trials by the Children s Cancer Group: CCG 251, CCG 213 and CCG Leukemia. 2005;19: Lie SO, Abrahamsson J, Clausen N, et al. Long-term results in children with AML: NOPHO-AML Study Group report of three consecutive trials. Leukemia. 2005;19: Ravindranath Y, Chang M, Steuber CP, et al. Pediatric Oncology Group (POG) studies of acute myeloid leukemia (AML): a review of four consecutive childhood AML trials conducted between 1981 and Leukemia. 2005;19: Ribeiro RC, Razzouk BI, Pounds S, Hijiya N, Pui CH, Rubnitz JE. Successive clinical trials for childhood acute myeloid leukemia at St Jude Children s Research Hospital, from 1980 to Leukemia. 2005;19: Gibson BE, Wheatley K, Hann IM, et al. Treatment strategy and long-term results in paediatric patients treated in consecutive UK AML trials. Leukemia. 2005;19: Webb DK, Wheatley K, Harrison G, Stevens RF, Hann IM. Outcome for children with relapsed acute myeloid leukaemia following initial therapy in the Medical Research Council (MRC) AML 10 trial. MRC Childhood Leukaemia Working Party. Leukemia. 1999;13: Stahnke K, Boos J, Bender-Gotze C, Ritter J, Zimmermann M, Creutzig U. Duration of first remission predicts remission rates and long-term survival in children with relapsed acute myelogenous leukemia. Leukemia. 1998;12: Aladjidi N, Auvrignon A, Leblanc T, et al. Outcome in children with relapsed acute myeloid leukemia after initial treatment with the French Leucemie Aique Myeloide Enfant (LAME) 89/ 91 protocol of the French Society of Pediatric Hematology and Immunology. JClinOncol. 2003;21: Wells RJ, Adams MT, Alonzo TA, et al. Mitoxantrone and cytarabine induction, high-dose cytarabine, and etoposide intensification for pediatric patients with relapsed or refractory acute myeloid leukemia: Children s Cancer Group Study JClinOncol. 2003;21: Johnston DL, Alonzo TA, Gerbing RB, Lange BJ, Woods WG. Risk factors and therapy for isolated central nervous system relapse of pediatric acute myeloid leukemia. JClinOncol. 2005;23: Kaplan EL, Meier P. Non-parametric estimation for incomplete observations. Am Stat Assoc. 1958;53: Peto R, Pike MC, Armitage P, et al. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. Analysis and examples. Br J Cancer. 1977; 35: Cox DR. Regression models and life-tables. J Res Stat Soc B. 1972;34: Rubnitz JE, Raimondi SC, Tong X, et al. Favorable impact of the t(9;11) in childhood acute myeloid leukemia. JClinOncol. 2002;20: Rubnitz JE, Raimondi SC, Halbert AR, et al. Characteristics and outcome of t(8;21)-positive childhood acute myeloid leukemia: a single institution s experience. Leukemia. 2002;16: Athale UH, Razzouk BI, Raimondi SC, et al. Biology and outcome of childhood acute megakaryoblastic leukemia: a single institution s experience. Blood. 2001;97: Razzouk BI, Raimondi SC, Srivastava DK, et al. Impact of treatment on the outcome of acute myeloid leukemia with inversion 16: a single institution s experience. Leukemia. 2001; 15: Santana VM, Mirro J Jr, Harwood FC, et al. A phase I clinical trial of 2-chlorodeoxyadenosine in pediatric patients with acute leukemia. JClinOncol. 1991;9: Santana VM, Mirro J Jr, Kearns C, Schell MJ, Crom W, Blakley RL. 2-Chlorodeoxyadenosine produces a high rate of complete hematologic remission in relapsed acute myeloid leukemia. JClinOncol. 1992;10: Rubnitz JE, Razzouk BI, Srivastava DK, Pui CH, Ribeiro RC, Santana VM. Phase II trial of cladribine and cytarabine in relapsed or refractory myeloid malignancies. Leuk Res. 2004; 28: Guzman ML, Swiderski CF, Howard DS, et al. Preferential induction of apoptosis for primary human leukemic stem cells. Proc Natl Acad Sci U S A. 2002;99:
7 Outcome After Recurrence of Childhood AML/Rubnitz et al Adams J. The proteasome: a suitable antineoplastic target. Nat Rev Cancer. 2004;4: Insinga A, Monestiroli S, Ronzoni S, et al. Inhibitors of histone deacetylases induce tumor-selective apoptosis through activation of the death receptor pathway. Nat Med. 2005;11: Nebbioso A, Clarke N, Voltz E, et al. Tumor-selective action of HDAC inhibitors involves TRAIL induction in acute myeloid leukemia cells. Nat Med. 2005;11: Levis M, Allebach J, Tse KF, et al. A FLT3-targeted tyrosine kinase inhibitor is cytotoxic to leukemia cells in vitro and in vivo. Blood. 2002;99: Brown P, Meshinchi S, Levis M, et al. Pediatric AML primary samples with FLT3/ITD mutations are preferentially killed by FLT3 inhibition. Blood. 2004;104: Smith BD, Levis M, Beran M, et al. Single-agent CEP-701, a novel FLT3 inhibitor, shows biologic and clinical activity in patients with relapsed or refractory acute myeloid leukemia. Blood. 2004;103: Miller JS, Soignier Y, Panoskaltsis-Mortari A, et al. Successful adoptive transfer and in vivo expansion of human haploidentical NK cells in patients with cancer. Blood. 2005;105:
A review of central nervous system leukaemia in paediatric acute myeloid leukaemia
EDITORIAL A review of central nervous system leukaemia in paediatric acute myeloid leukaemia Donna L. Johnston Division of Hematology/Oncology, Children s Hospital of Eastern Ontario, Ottawa, Ontario,
More informationMUD SCT for Paediatric AML?
7 th South African Symposium on Haematopoietic Stem Cell Transplantation MUD SCT for Paediatric AML? Alan Davidson Haematology / Oncology Service Red Cross Children s Hospital THE SCENARIO A 10 year old
More informationJ Clin Oncol 29: by American Society of Clinical Oncology INTRODUCTION
VOLUME 29 NUMBER 3 JANUARY 20 2011 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T Response-Guided Induction Therapy in Pediatric Acute Myeloid Leukemia With Excellent Remission Rate Jonas Abrahamsson,
More informationAcute Myeloid Leukemia
S E C T I O N B Acute Myeloid Leukemia B. Lange & Brenda Gibson Introduction In the past decade cooperative groups in France, Germany, Scandinavia, the United Kingdom, and the United States have reported
More informationJohann Hitzler, MD, FRCPC, FAAP Jacqueline Halton, MD, FRCPC Jason D. Pole, PhD
Photo by Tynan Studio Johann Hitzler, MD, FRCPC, FAAP Jacqueline Halton, MD, FRCPC Jason D. Pole, PhD 96 Atlas of Childhood Cancer in Ontario (1985-2004) Chapter 6: Leukemia 6 Leukemia Atlas of Childhood
More informationAcute myeloid leukemia: prognosis and treatment. Dimitri A. Breems, MD, PhD Internist-Hematoloog Ziekenhuis Netwerk Antwerpen Campus Stuivenberg
Acute myeloid leukemia: prognosis and treatment Dimitri A. Breems, MD, PhD Internist-Hematoloog Ziekenhuis Netwerk Antwerpen Campus Stuivenberg Patient Female, 39 years History: hypothyroidism Present:
More informationOutcome of acute leukemia patients with central nervous system (CNS) involvement treated with total body or CNS irradiation before transplantation
Original Article Page 1 of 9 Outcome of acute leukemia patients with central nervous system (CNS) involvement treated with total body or CNS irradiation before transplantation Wen-Han Kuo 1, Yu-Hsuan Chen
More informationHEMATOLOGIC MALIGNANCIES BIOLOGY
HEMATOLOGIC MALIGNANCIES BIOLOGY Failure of terminal differentiation Failure of differentiated cells to undergo apoptosis Failure to control growth Neoplastic stem cell FAILURE OF TERMINAL DIFFERENTIATION
More informationCorporate Medical Policy. Policy Effective February 23, 2018
Corporate Medical Policy Genetic Testing for FLT3, NPM1 and CEBPA Mutations in Acute File Name: Origination: Last CAP Review: Next CAP Review: Last Review: genetic_testing_for_flt3_npm1_and_cebpa_mutations_in_acute_myeloid_leukemia
More informationFirst relapsed childhood ALL Role of chemotherapy
First relapsed childhood ALL Role of chemotherapy Thirachit Chotsampancharoen, M.D. Division of Pediatric Hematology/Oncology Department of Pediatrics Prince of Songkla University Hat-Yai, Songkhla 25
More informationEvolving Targeted Management of Acute Myeloid Leukemia
Evolving Targeted Management of Acute Myeloid Leukemia Jessica Altman, MD Robert H. Lurie Comprehensive Cancer Center of Northwestern University Learning Objectives Identify which mutations should be assessed
More informationMyeloperoxidase Expression in Acute Myeloid Leukemia Helps Identifying Patients to Benefit from Transplant
Original Article http://dx.doi.org/1349/ymj.212.53.3.53 pissn: 513-5796, eissn: 1976-2437 Yonsei Med J 53(3):53-536, 212 Myeloperoxidase Expression in Acute Myeloid Leukemia Helps Identifying Patients
More informationAcute myeloid leukemia. M. Kaźmierczak 2016
Acute myeloid leukemia M. Kaźmierczak 2016 Acute myeloid leukemia Malignant clonal disorder of immature hematopoietic cells characterized by clonal proliferation of abnormal blast cells and impaired production
More informationSelinexor: Novel Anti-Cancer Agent: Restores Tumor Suppressors & Reduces Oncoproteins
PHASE I STUDY OF SELINEXOR, A SELECTIVE INHIBITOR OF NUCLEAR EXPORT, IN COMBINATION WITH FLUDARABINE AND CYTARABINE IN CHILDREN WITH RELAPSED OR REFRACTORY LEUKEMIA Thomas B Alexander 1, Norman J Lacayo
More informationBackground CPX-351. Lancet J, et al. J Clin Oncol. 2017;35(suppl): Abstract 7035.
Overall Survival (OS) With Versus in Older Adults With Newly Diagnosed, Therapy-Related Acute Myeloid Leukemia (taml): Subgroup Analysis of a Phase 3 Study Abstract 7035 Lancet JE, Rizzieri D, Schiller
More informationLife Science Journal 2013;10(4)
Chidhood AML: Is It Difficult To Cure? King Fahd Specialist Hospital Damman Experience Saad A.Al Daama 1, Afra Q.Aldayel. 2,3. Sameera Alafgani 1,Mohamed Abolela 1, Hossam A. Ayad 1, Arwa Al Saber 3, Heba
More informationThe tenth acute myeloid leukemia (AML) trial conducted
CLINICL UPDTE U p d a t e s o n s t u d y f i n d i n g s i n e s s e n t i a l t h e r a p e u t i c a r e a s o f c a n c e r a n d b l o o d d i s o r d e r s Long-term Results of the MRC ML1 Trial
More informationN Engl J Med Volume 373(12): September 17, 2015
Review Article Acute Myeloid Leukemia Hartmut Döhner, M.D., Daniel J. Weisdorf, M.D., and Clara D. Bloomfield, M.D. N Engl J Med Volume 373(12):1136-1152 September 17, 2015 Acute Myeloid Leukemia Most
More informationMedical Policy. MP Hematopoietic Cell Transplantation for Acute Myeloid Leukemia
Medical Policy MP 8.01.26 BCBSA Ref. Policy: 8.01.26 Last Review: 01/30/2018 Effective Date: 01/30/2018 Section: Therapy Related Policies 2.04.124 Genetic Testing for FLT3, NPM1, and CEBPA Variants in
More informationCorporate Medical Policy
Corporate Medical Policy Hematopoietic Stem-Cell Transplantation for Acute Myeloid File Name: Origination: Last CAP Review: Next CAP Review: Last Review: hematopoietic_stem-cell_transplant_for_acute_myeloid_leukemia
More informationStem cell transplantation for patients with AML in Republic of Macedonia: - 15 years of experience -
Stem cell transplantation for patients with AML in Republic of Macedonia: - 15 years of experience - R E S E A R C H A S S O C I A T E P R O F. D - R Z L A T E S T O J A N O S K I Definition Acute myeloid
More informationIntroduction. of some recurrent aberrations, for example, 8, del(9q), or CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients
More informationTreatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down s syndrome: results of NOPHO-AML trials
British Journal of Haematology, 2003, 122, 217 225 Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down s syndrome: results of NOPHO-AML trials
More informationCLINICAL STUDY REPORT SYNOPSIS
CLINICAL STUDY REPORT SYNOPSIS Document No.: EDMS-PSDB-5412862:2.0 Research & Development, L.L.C. Protocol No.: R115777-AML-301 Title of Study: A Randomized Study of Tipifarnib Versus Best Supportive Care
More informationAll patients with FLT3 mutant AML should receive midostaurin-based induction therapy. Not so fast!
All patients with FLT3 mutant AML should receive midostaurin-based induction therapy Not so fast! Harry P. Erba, M.D., Ph.D. Professor, Internal Medicine Director, Hematologic Malignancy Program University
More information소아급성골수성백혈병의진단및치료. Diagnosis and Treatment of Pediatric Acute Myeloid Leukemia 이재욱ㆍ조빈. Introduction
Clinical Pediatric Hematology-Oncology Volume 22 ㆍ Number 1 ㆍ April 2015 REVIEW ARTICLE 소아급성골수성백혈병의진단및치료 이재욱ㆍ조빈 가톨릭대학교의과대학소아과학교실 Diagnosis and Treatment of Pediatric Acute Myeloid Leukemia Jae Wook Lee,
More informationElisabeth Koller 3rd Medical Dept., Center for Hematology and Oncology, Hanusch Hospital, Vienna, Austria
Elisabeth Koller 3rd Medical Dept., Center for Hematology and Oncology, Hanusch Hospital, Vienna, Austria Incidence Diagnosis Prognostic factors Treatment Induction therapy - HSCT Indications for HSCT
More informationReference: NHS England 1602
Clinical Commissioning Policy Proposition: Clofarabine for refractory or relapsed acute myeloid leukaemia (AML) as a bridge to stem cell transplantation Reference: NHS England 1602 First published: TBC
More informationSummary. Olga Zając, Katarzyna Derwich, Katarzyna Stefankiewicz, Jacek Wachowiak. Rep Pract Oncol Radiother, 2007; 12(5):
Rep Pract Oncol Radiother, 2007; 12(5): 283-288 Preliminary Communication Received: 2007.03.27 Accepted: 2007.07.24 Published: 2007.10.18 Authors Contribution: A Study Design B Data Collection C Statistical
More informationKEY WORDS: CRp, Platelet recovery, AML, MDS, Transplant
Platelet Recovery Before Allogeneic Stem Cell Transplantation Predicts Posttransplantation Outcomes in Patients with Acute Myelogenous Leukemia and Myelodysplastic Syndrome Gheath Alatrash, Matteo Pelosini,
More informationPhiladelphia chromosome-positive acute lymphoblastic leukemia in childhood
Review article DOI: 10.3345/kjp.2011.54.3.106 Korean J Pediatr 2011;54(3):106-110 Philadelphia chromosome-positive acute lymphoblastic leukemia in childhood Hong Hoe Koo, M.D., Ph.D. Department of Pediatrics,
More informationIntroduction CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Comparison of idarubicin ara-c, fludarabine ara-c, and topotecan ara-c based regimens in treatment of newly diagnosed acute myeloid leukemia,
More informationSTUDY OF PROGNOSIS IN ACUTE MYELOID LEUKEMIAS (AML) BY CLUSTER ANALYSIS
original papers Haematologica 1994; 79:233-240 STUDY OF PROGNOSIS IN ACUTE MYELOID LEUKEMIAS (AML) BY CLUSTER ANALYSIS Gian Matteo Rigolin, Franca Fagioli, Romedio Spanedda, Gianluigi Scapoli, Francesco
More informationKeywords: Acute Myeloid Leukemia, FLT3-ITD Mutation, FAB Subgroups, Cytogenetic Risk Groups
Original Articleeee fms Like Tyrosine kinase3- Internal Tandem Duplication (FLT3-ITD) in Acute Myeloid Leukemia, Mutation Frequency and its Relation with Complete Remission, 2007-2008 Emami AH, 1 Shekarriz
More informationSUPPLEMENTARY FIG. S3. Kaplan Meier survival analysis followed with log-rank test of de novo acute myeloid leukemia patients selected by age <60, IA
Supplementary Data Supplementary Appendix A: Treatment Protocols Treatment protocols of 123 cases patients were treated with the protocols as follows: 110 patients received standard DA (daunorubicin 45
More informationAppendix 6: Indications for adult allogeneic bone marrow transplant in New Zealand
Appendix 6: Indications for adult allogeneic bone marrow transplant in New Zealand This list provides indications for the majority of adult BMTs that are performed in New Zealand. A small number of BMTs
More informationAcute Lymphoblastic and Myeloid Leukemia
Acute Lymphoblastic and Myeloid Leukemia Pre- and Post-Disease Form Acute Lympoblastic Leukemia Mary Eapen MD, MS Acute Lymphoblastic Leukemia SEER Age-adjusted incidence rate 1.6 per 100,000 men and women
More informationCorrelation of Sex and Remission of Acute Lymphoblastic Leukemia-L1 (ALL-L1) in Children
International Journal of Clinical and Experimental Medical Sciences 2015; 1(2): 11-15 Published online July 6, 2015 (http://www.sciencepublishinggroup.com/j/ijcems) doi: 10.11648/j.ijcems.20150102.12 Correlation
More informationSWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL LEUKEMIA FORMS CHAPTER 16A REVISED: DECEMBER 2017
LEUKEMIA FORMS The guidelines and figures below are specific to Leukemia studies. The information in this manual does NOT represent a complete set of required forms for any leukemia study. Please refer
More informationDonor Lymphocyte Infusion for Malignancies Treated with an Allogeneic Hematopoietic Stem-Cell Transplant
Last Review Status/Date: September 2014 Page: 1 of 8 Malignancies Treated with an Allogeneic Description Donor lymphocyte infusion (DLI), also called donor leukocyte or buffy-coat infusion is a type of
More informationEarly Clearance of Peripheral Blood Blasts Predicts Response to Induction Chemotherapy in Acute Myeloid Leukemia
Early Clearance of Peripheral Blood Blasts Predicts Response to Induction Chemotherapy in Acute Myeloid Leukemia Martha Arellano, MD 1 ; Suchita Pakkala, MD 1 ; Amelia Langston, MD 1 ; Mourad Tighiouart,
More informationRemission induction in acute myeloid leukemia
Int J Hematol (2012) 96:164 170 DOI 10.1007/s12185-012-1121-y PROGRESS IN HEMATOLOGY How to improve the outcome of adult acute myeloid leukemia? Remission induction in acute myeloid leukemia Eytan M. Stein
More informationTHE LEUKEMIAS. Etiology:
The Leukemias THE LEUKEMIAS Definition 1: malignant transformation of the pluripotent stem cell, successive expansion of the malignant clone from the bone marrow to the tissues Definition 2: Heterogenous
More informationImproved outcome in childhood ALL with intensive consolidation and hematopoietic stem cell transplant
VOLUME 45 ㆍ NUMBER 2 ㆍ June 2010 THE KOREAN JOURNAL OF HEMATOLOGY ORIGINAL ARTICLE Improved outcome in childhood ALL with intensive consolidation and hematopoietic stem cell transplant Jeong A Park 1,
More informationAllogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Neoplasms. Policy Specific Section:
Medical Policy Allogeneic Hematopoietic Stem-Cell Transplantation for Myelodysplastic Syndromes and Myeloproliferative Type: Medical Necessity and Investigational / Experimental Policy Specific Section:
More informationNew treatment strategies in myelodysplastic syndromes and acute myeloid leukemia van der Helm, Lidia Henrieke
University of Groningen New treatment strategies in myelodysplastic syndromes and acute myeloid leukemia van der Helm, Lidia Henrieke IMPORTANT NOTE: You are advised to consult the publisher's version
More informationIndication for unrelated allo-sct in 1st CR AML
Indication for unrelated allo-sct in 1st CR AML It is time to say! Decision of allo-sct: factors to be considered Cytogenetic risk status Molecular genetics FLT3; NPM1, CEBPA. Response to induction Refractoriness
More informationLong-Term Outcome of Autologous Hematopoietic Stem Cell Transplantation (AHSCT) for Acute Myeloid Leukemia (AML)- Single Center Retrospective Analysis
Pathol. Oncol. Res. (2018) 24:469 475 DOI 10.1007/s12253-017-0266-7 ORIGINAL ARTICLE Long-Term Outcome of Autologous Hematopoietic Stem Cell Transplantation (AHSCT) for Acute Myeloid Leukemia (AML)- Single
More informationCytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia
Published Ahead of Print on December 19, 2014, as doi:10.3324/haematol.2014.117267. Copyright 2014 Ferrata Storti Foundation. Cytogenetic heterogeneity negatively impacts outcomes in patients with acute
More informationConcomitant WT1 mutations predicted poor prognosis in CEBPA double-mutated acute myeloid leukemia
Concomitant WT1 mutations predicted poor prognosis in CEBPA double-mutated acute myeloid leukemia Feng-Ming Tien, Hsin-An Hou, Jih-Luh Tang, Yuan-Yeh Kuo, Chien-Yuan Chen, Cheng-Hong Tsai, Ming Yao, Chi-Cheng
More informationCurrent Indications of Bone Marrow Transplantation (BMT) in Pediatric Malignant Conditions; a Review
EXPERT OPINION Current Indications of Bone Marrow Transplantation (BMT) in Pediatric Malignant Conditions; a Review Chi-Kong Li Department of Pediatrics, Prince of Wales Hospital, The Chinese University
More informationPrevious Study Return to List Next Study
A service of the U.S. National Institutes of Health Trial record 1 of 1 for: ASP 2215-cl-0101 Previous Study Return to List Next Study Dose Escalation Study Inv e stigating the Safe ty, Tole rability,
More informationIntroduction. Methods. The University of North Carolina Chapel Hill Investigational Review Board approved this study.
Abstract Background: Salvage chemotherapy regimens for patients with relapsed/refractory acute myeloid leukemia (AML) are associated with complete response rates of 30-60%. Determining the superiority
More informationBlast transformation in chronic myelomonocytic leukemia: Risk factors, genetic features, survival, and treatment outcome
RESEARCH ARTICLE Blast transformation in chronic myelomonocytic leukemia: Risk factors, genetic features, survival, and treatment outcome AJH Mrinal M. Patnaik, 1 Emnet A. Wassie, 1 Terra L. Lasho, 2 Curtis
More informationRisk factors and clinical outcomes of acute myeloid leukaemia with central nervous system involvement in adults
Cheng et al. BMC Cancer (2015) 15:344 DOI 10.1186/s12885-015-1376-9 RESEARCH ARTICLE Open Access Risk factors and clinical outcomes of acute myeloid leukaemia with central nervous system involvement in
More informationHow I treat pediatric acute myeloid leukemia
How I treat How I treat pediatric acute myeloid leukemia Jeffrey E. Rubnitz 1,2 1 Department of Oncology, St Jude Children s Research Hospital, Memphis, TN; and 2 Department of Pediatrics, College of Medicine,
More informationSingle Technology Appraisal (STA) Midostaurin for untreated acute myeloid leukaemia
Single Technology Appraisal (STA) Midostaurin for untreated acute myeloid leukaemia Response to consultee and commentator comments on the draft remit and draft scope (pre-referral) Please note: Comments
More informationDESCRIPTION OF SUPPLEMENT (METHODS):
DESCRIPTION OF SUPPLEMENT (METHODS): Included in this supplement is additional detail for the: I. Search strategy including databases, search dates, and the specific terms and combinations used II. Statistical
More informationDr Claire Burney, Lymphoma Clinical Fellow, Bristol Haematology and Oncology Centre, UK
EMBT LWP 2017-R-05 Research Protocol: Outcomes of patients treated with Ibrutinib post autologous stem cell transplant for mantle cell lymphoma. A retrospective analysis of the LWP-EBMT registry. Principle
More informationCytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia
Acute Myeloid Leukemia Articles Cytogenetic heterogeneity negatively impacts outcomes in patients with acute myeloid leukemia Bruno C. Medeiros, 1 Megan Othus, 2,3 Min Fang, 3,4 Frederick R. Appelbaum,
More informationRecommended Timing for Transplant Consultation
REFERRAL GUIDELINES Recommended Timing for Transplant Consultation Published jointly by the National Marrow Donor Program /Be The Match and the American Society for Blood and Marrow Transplantation BeTheMatchClinical.org
More informationCharacteristics and Outcome of Therapy-Related Acute Promyelocytic Leukemia After Different Front-line Therapies
Characteristics and Outcome of Therapy-Related Acute Promyelocytic Leukemia After Different Front-line Therapies Sabine Kayser, * Julia Krzykalla, Michelle A. Elliott, Kelly Norsworthy, Patrick Gonzales,
More informationAbstract 861. Stein AS, Topp MS, Kantarjian H, Gökbuget N, Bargou R, Litzow M, Rambaldi A, Ribera J-M, Zhang A, Zimmerman Z, Forman SJ
Treatment with Anti-CD19 BiTE Blinatumomab in Adult Patients With Relapsed/Refractory B-Precursor Acute Lymphoblastic Leukemia (R/R ALL) Post-Allogeneic Hematopoietic Stem Cell Transplantation Abstract
More informationJeanne Palmer February 26, 2017 Mayo Clinic, Phoenix, AZ
Jeanne Palmer February 26, 2017 Mayo Clinic, Phoenix, AZ What is acute leukemia? Cancer of the white blood cells Acute leukemia- Acute myelogenous leukemia Acute myeloid leukemia Myelofibrosis- Blast phase
More informationAcute Lymphoblastic Leukemia (ALL) Ryan Mattison, MD University of Wisconsin March 2, 2010
Acute Lymphoblastic Leukemia (ALL) Ryan Mattison, MD University of Wisconsin March 2, 2010 ALL Epidemiology 20% of new acute leukemia cases in adults 5200 new cases in 2007 Most are de novo Therapy-related
More informationBone Marrow Transplantation and the Potential Role of Iomab-B
Bone Marrow Transplantation and the Potential Role of Iomab-B Hillard M. Lazarus, MD, FACP Professor of Medicine, Director of Novel Cell Therapy Case Western Reserve University 1 Hematopoietic Cell Transplantation
More informationMonosomal Karyotype Provides Better Prognostic Prediction after Allogeneic Stem Cell Transplantation in Patients with Acute Myelogenous Leukemia
Monosomal Karyotype Provides Better Prognostic Prediction after Allogeneic Stem Cell Transplantation in Patients with Acute Myelogenous Leukemia Betul Oran, 1 Michelle Dolan, 2 Qing Cao, 1 Claudio Brunstein,
More informationOncologist. The. Pediatric Oncology. Prognostic Factors and Risk-Based Therapy in Pediatric Acute Myeloid Leukemia
The Oncologist Pediatric Oncology Prognostic Factors and Risk-Based Therapy in Pediatric Acute Myeloid Leukemia SOHEIL MESHINCHI, a ROBERT J. ARCECI b a Fred Hutchinson Cancer Research Center, University
More informationLaboratory Correlates and Prognostic Significance of Granular Acute Lymphoblastic Leukemia in Children A Pediatric Oncology Group Study
HEMATOPATHQLOGY AND LABORATORY HEMATOLOGY Original Article Laboratory Correlates and Prognostic Significance of Granular Acute Lymphoblastic Leukemia in Children A Pediatric Oncology Group Study LIZARDO
More informationAcute Myeloid Leukemia
Acute Myeloid Leukemia Pimjai Niparuck Division of Hematology, Department of Medicine Ramathibodi Hospital, Mahidol University Outline Molecular biology Chemotherapy and Hypomethylating agent Novel Therapy
More informationTreatment of AML in biological subgroups
Hematology, 2005; 10 Supplement 1: 281 /285 ACUTE MYELOID LEUKEMIA Treatment of AML in biological subgroups THOMAS BUECHNER, WOLFGANG E. BERDEL, CLAUDIA SCHOCH, TORSTEN HAFERLACH, HUBERT L. SERVE, SUSANNE
More informationASBMT and Marrow Transplantation
Biol Blood Marrow Transplant 19 (2013) 661e675 Brief Articles Improved Survival over the Last Decade in Pediatric Patients Requiring Dialysis after Hematopoietic Cell Transplantation American Society for
More informationCopyright information:
Favorable Survival Maintained in Children Who Have Myeloid Leukemia Associated With Down Syndrome Using Reduced-Dose Chemotherapy on Children s Oncology Group Trial A2971 April D. Sorrell, City Hope National
More informationSystemic Treatment of Acute Myeloid Leukemia (AML)
Guideline 12-9 REQUIRES UPDATING A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Systemic Treatment of Acute Myeloid Leukemia (AML) Members of the Acute Leukemia
More informationTreatment strategy and long-term results in paediatric patients treated in consecutive UK AML trials
(2005) 19, 2130 2138 & 2005 Nature Publishing Group All rights reserved 0887-6924/05 $30.00 www.nature.com/leu treated in consecutive UK AML trials BES Gibson 1, K Wheatley 2, IM Hann 3, RF Stevens 4,
More informationManagement of Extramedullary Leukemia as a Presentation of Acute Myeloid Leukemia
Original Article 1165 of Extramedullary Leukemia as a Presentation of Acute Myeloid Leukemia Samuel J. Slomowitz, MD, and Paul J. Shami, MD Abstract Extramedullary involvement is considered to be an uncommon
More informationPage: 1 of 12. Genetic Testing for FLT3, NPM1, and CEBPA Mutations in Acute Myeloid Leukemia
Page: 1 of 12 Last Review Status/Date: September 2015 Genetic Testing for FLT3, NPM1, and CEBPA Mutations in Acute Myeloid Description Treatment of acute myeloid leukemia (AML) is based upon risk stratification,
More informationBone Marrow Transplantation in Myelodysplastic Syndromes. An overview for the Myelodysplasia Support Group of Ottawa
Bone Marrow Transplantation in Myelodysplastic Syndromes An overview for the Myelodysplasia Support Group of Ottawa Objectives Provide brief review of marrow failure Re emphasize the importance of predictions
More informationDOWNLOAD OR READ : TREATMENT OF ACUTE LEUKEMIAS NEW DIRECTIONS FOR CLINICAL RESEARCH REPRINT PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : TREATMENT OF ACUTE LEUKEMIAS NEW DIRECTIONS FOR CLINICAL RESEARCH REPRINT PDF EBOOK EPUB MOBI Page 1 Page 2 treatment of acute leukemias new directions for clinical research reprint
More informationTransplants for MPD and MDS
Transplants for MPD and MDS The question is really who to transplant, with what and when. Focus on myelofibrosis Jeff Szer Royal Melbourne Hospital Myelodysplasia Little needs to be said Despite new therapies
More informationJPMA ( Journal Of Pakistan Medical Association) Vol 53, No.9,Sep Original Articles
JPMA ( Journal Of Pakistan Medical Association) Vol 53, No.9,Sep. 2003 Original Articles Outcome of Adult Acute Lymphoblastic Leukemia: a Single Center Experience M. Usman, I. Burney*, A. Nasim*, S. N.
More informationImpact of Day 14 Bone Marrow Biopsy on Re-Induction Decisions and Prediction of a Complete Response in Acute Myeloid Leukemia Cases
DOI:10.22034/APJCP.2018.19.2.421 RESEARCH ARTICLE Editorial Process: Submission:08/01/2017 Acceptance:12/09/2017 Impact of Day 14 Bone Marrow Biopsy on Re-Induction Decisions and Prediction of a Complete
More informationResearch Article Prognostic Factors in Advanced Non-Small-Cell Lung Cancer Patients: Patient Characteristics and Type of Chemotherapy
SAGE-Hindawi Access to Research Lung Cancer International Volume 2011, Article ID 152125, 4 pages doi:10.4061/2011/152125 Research Article Prognostic Factors in Advanced Non-Small-Cell Lung Cancer Patients:
More informationDonatore HLA identico di anni o MUD giovane?
Donatore HLA identico di 60-70 anni o MUD giovane? Stella Santarone Dipartimento di Ematologia, Medicina Trasfusionale e Biotecnologie Pescara AGENDA 1. Stem Cell Donation: fatalities and severe events
More informationATRA (ALLTransretinoic acid) drug in treatment of APL (Acute promylocytic leukemia) Mouroge H. Al-Ani Jaffer M. Al-Gabban, Suzan Mahmood MD
ATRA (ALLTransretinoic acid) drug in treatment of APL (Acute promylocytic leukemia) Mouroge H. Al-Ani Jaffer M. Al-Gabban, CABP CABP Suzan Mahmood MD Background: Acute propmylocytic leukemia APL is a subgroup
More informationAcute myeloid leukemia in children: Current status and future directions
Pediatrics International (2016) 58, 71 80 doi: 10.1111/ped.12865 Review Article Acute myeloid leukemia in children: Current status and future directions Takashi Taga, 1 Daisuke Tomizawa, 2 Hiroyuki Takahashi
More informationNational Horizon Scanning Centre. Azacitidine (Vidaza) for myelodysplastic syndrome. September 2007
Azacitidine (Vidaza) for myelodysplastic syndrome September 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to
More informationPDF of Trial CTRI Website URL -
Clinical Trial Details (PDF Generation Date :- Wed, 19 Dec 2018 02:45:15 GMT) CTRI Number Last Modified On 25/12/2017 Post Graduate Thesis Type of Trial Type of Study Study Design Public Title of Study
More informationMinimal residual disease (MRD) in AML; coming of age. Dr. Mehmet Yılmaz Gaziantep University Medical School Sahinbey Education and Research hospital
Minimal residual disease (MRD) in AML; coming of age Dr. Mehmet Yılmaz Gaziantep University Medical School Sahinbey Education and Research hospital 1. The logistics of MRD assessment in AML 2. The clinical
More informationAIH, Marseille 30/09/06
ALLOGENEIC STEM CELL TRANSPLANTATION FOR MYELOID MALIGNANCIES Transplant and Cellular Therapy Unit Institut Paoli Calmettes Inserm U599 Université de la Méditerranée ée Marseille, France AIH, Marseille
More informationNeue zielgerichtete Behandlungsoptionen der neu diagnostizierten FLT3-positiven Akuten Myeloischen Leukämie (AML)
Neue zielgerichtete Behandlungsoptionen der neu diagnostizierten FLT3-positiven Akuten Myeloischen Leukämie (AML) Prof. Hartmut Döhner Klinik für Innere Medizin III, Universitätsklinikum Ulm Midostaurin
More informationUniversity of Groningen
University of Groningen The prognostic significance of early treatment response in pediatric relapsed acute myeloid leukemia Creutzig, Ursula; Zimmermann, Martin; Dworzak, Michael N.; Gibson, Brenda; Tamminga,
More informationPersonalized Therapy for Acute Myeloid Leukemia. Patrick Stiff MD Loyola University Medical Center
Personalized Therapy for Acute Myeloid Leukemia Patrick Stiff MD Loyola University Medical Center 708-327-3216 Major groups of Mutations in AML Targets for AML: Is this Achievable? Chronic Myeloid Leukemia:
More informationSuccesses and challenges in the treatment of pediatric acute myeloid leukemia: a retrospective analysis of the AML-BFM trials from 1987 to 2012
Leukemia https://doi.org/1.138/s41375-18-71-7 ARTICLE Acute myeloid leukemia Successes and challenges in the treatment of pediatric acute myeloid leukemia: a retrospective analysis of the AML-BFM trials
More informationMyelodyspastic Syndromes
Myelodyspastic Syndromes SUPPLEMENTARY APPENDIX Complex or monosomal karyotype and not blast percentage is associated with poor survival in acute myeloid leukemia and myelodysplastic syndrome patients
More informationScottish Medicines Consortium
Scottish Medicines Consortium azacitidine 100mg powder for suspension for injection (Vidaza ) No. (589/09) Celgene Ltd 05 March 2010 The Scottish Medicines Consortium (SMC) has completed its assessment
More informationPediatric Acute Leukemia: The Effect of Prognostic Factors on Clinical Outcomes at Phramongkutklao Hospital, Bangkok, Thailand
Pediatric Acute Leukemia: The Effect of Prognostic Factors on Clinical Outcomes at Phramongkutklao Hospital, Bangkok, Thailand Piya Rujkijyanont MD*, Suphathida Kaewinsang MD*, Chalinee Monsereenusorn
More informationCHILDHOOD CANCER SURVIVOR STUDY Long-Term Morbidity in Survivors of Childhood Leukemia with Down Syndrome Analysis Concept Proposal
CHILDHOOD CANCER SURVIVOR STUDY Long-Term Morbidity in of Childhood Leukemia with Down Syndrome Analysis Concept Proposal Working Group and Investigators Genetics Working Group & Chronic Disease Working
More informationNational Institute for Health and Care Excellence. Single Technology Appraisal (STA)
Single Technology Appraisal (STA) Gemtuzumab ozogamacin for untreated de novo acute myeloid leukaemia Response to consultee and commentator comments re-scope Please note: Comments received in the course
More information