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Titolo:
Prognosis of patients with a second relapse of acute myeloid leukemia
Autore:
Stoiser, B; Knobl, P; Fonatsch, C; Haas, OA; Mitterbauer, G; Weltermann, A; Geissler, K; Valent, P; Sperr, W; Pabinger, I; Lechner, K; Jaeger, U;
Indirizzi:
St Anna Childrens Hosp, Dept Internal Med 1, Div Hematol & Hemostaseol, A-1090 Vienna, Austria St Anna Childrens Hosp Vienna Austria A-1090 eol, A-1090 Vienna, Austria St Anna Childrens Hosp, Inst Med Biol, A-1090 Vienna, Austria St Anna Childrens Hosp Vienna Austria A-1090 iol, A-1090 Vienna, Austria St Anna Childrens Hosp, Childrens Canc Res Inst, A-1090 Vienna, Austria StAnna Childrens Hosp Vienna Austria A-1090 nst, A-1090 Vienna, Austria Univ Vienna, Inst Lab Med, A-1010 Vienna, Austria Univ Vienna Vienna Austria A-1010 , Inst Lab Med, A-1010 Vienna, Austria
Titolo Testata:
LEUKEMIA
fascicolo: 12, volume: 14, anno: 2000,
pagine: 2059 - 2063
SICI:
0887-6924(200012)14:12<2059:POPWAS>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYELOGENOUS LEUKEMIA; ACUTE PROMYELOCYTIC LEUKEMIA; LONG-TERM SURVIVAL; CHROMOSOME-ABERRATIONS; SINGLE-CENTER; REMISSION; CHEMOTHERAPY; CLASSIFICATION; EXPERIENCE; MANAGEMENT;
Keywords:
AML; second relapse; karyotype; prognostic factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Life Sciences
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Jaeger, U St Anna Childrens Hosp, Dept Internal Med 1, Div Hematol & Hemostaseol, Wahringer Gurtel 18-20, A-1090 Vienna, Austria St Anna Childrens Hosp Wahringer Gurtel 18-20 Vienna Austria A-1090
Citazione:
B. Stoiser et al., "Prognosis of patients with a second relapse of acute myeloid leukemia", LEUKEMIA, 14(12), 2000, pp. 2059-2063

Abstract

Recurrence of the disease is the major problem in the treatment of acute myeloid leukemia (AML). The majority of patients who achieve a second remission will ultimately relapse. In this retrospective single-center study, we have analyzed the outcome of patients with a second relapse and tried to define the prognostic factors in intensively treated patients. Of 534 patients with AML, 62 had a second relapse. Thirty-three received further intensive chemotherapy (CT). Eighteen patients (55%) achieved a third complete remission (CR). The early death (ED) rate was only 9%. The overall survival (OS) of treated vs untreated patients was 6.9 vs 1.3 months, respectively (P =0.01). The major selection criteria for a third CT were a favourable (t(15;17),t(8;21),inv(16)) or normal karyotype, long (>11 months) second CR (P less than or equal to 0.005) and no previous bone marrow transplantation (BMT)(P < 0.01). Favorable or normal karyotype, second CR >11 months, as well as no previous BMT (P < 0.01) were associated with the achievement of a third CR. Favorable (P < 0.005) or normal karyotype (P < 0.01), as well as a second CR >11 months (P < 0.005) were associated with prolonged survival after CT. The median OS for patients receiving CT with favorable or normal cytogenetics, a second CR > 11 months, but no previous BMT was 26.5 months. Five patients with favorable or normal karyotype achieved a fourth or fifth remission. We conclude that intensive CT is associated with a survival benefit and good quality of life if patients are properly selected.

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Documento generato il 21/09/20 alle ore 15:43:13