Results of program acute myeloid leukemia therapy use in National Medical Research Center for Hematology of the Ministry of Health of Russian Federation
| العنوان: | Results of program acute myeloid leukemia therapy use in National Medical Research Center for Hematology of the Ministry of Health of Russian Federation |
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| المؤلفون: | Irina V. Galtseva, T N Obukhova, S A Kuznetsova, Larisa A. Kuzmina, A N Sokolov, V A Vasilyeva, J O Davidiva, Elena N. Parovichnikova, Valery G. Savchenko, Olga A. Gavrilina, Vera V. Troitskaya, I A Loukianova, Sergei M. Kulikov, Zalina T. Fidarova, Andrey Sudarikov, Mikhail Yu. Drokov, V.N. Dvirnik, T I Lobaova, A V Kokhno, G A Baskhaeva |
| المصدر: | Терапевтический архив, Vol 90, Iss 7, Pp 14-22 (2018) |
| بيانات النشر: | "Consilium Medicum" Publishing house, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Male, History, medicine.medical_specialty, Anthracycline, Adolescent, Daunorubicin, Endocrinology, Diabetes and Metabolism, allogenic blood stem cells transplantation, lcsh:Medicine, acute myeloid leukemia, Disease-Free Survival, Russia, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Idarubicin, Humans, Mitoxantrone, Hematology, Antibiotics, Antineoplastic, Dose-Response Relationship, Drug, business.industry, lcsh:R, Cytarabine, Myeloid leukemia, risk group, General Medicine, Induction Chemotherapy, Middle Aged, Prognosis, Transplantation, Consolidation Chemotherapy, Survival Rate, Leukemia, Myeloid, Acute, 030220 oncology & carcinogenesis, Female, Family Practice, business, 030215 immunology, medicine.drug |
| الوصف: | Objective. To analyze treatment results of 172 patients with acute myeloid leukemia (AML) aged 18-60 years in National Medical Research Center for Hematology of MHRF. Materials and methods. Inductive and consolidation program for 139 (80%) patients was based on a standardized protocol: 4 courses “7+3” with different anthracycline use (2 courses of daunorubicin, idarubicin, mitoxantrone) and continuous use of cytarabine on the second inductive course. In 20% of patients cytarabine courses at the dose of 1 g/m2 2 times a day for 1-3 days combined with idarubicin and mitoxantrone were used as two consolidation courses. Allogenic bone marrow transplantation was performed in the first complete remission (CR) period in 40% of patients. Results. The frequency of CR achievement in all patients was 78.6%, refractory forms were observed in 13.9% of patients, early mortality - in 7.5% of patients. Seven-year overall survival (OS) rate was 40.7%, relapse free survival (RFS) - 43.2%. When estimating effectiveness depending on cytogenetic risk group it was demonstrated that 5-year OS and RFS in patients with translocation (8; 21) cannot be considered as satisfying, it accounted for 50 and 34%, respectively. At the same time in patients with 16th chromosome inversion (inv16) these characteristics accounted for 68.6 and 63.5%. Acquired results forced reconsidering of the consolidation program in AML patients of this subgroup. The median time to allogenic blood stem cells transplantation (allo-BSCT) in patients with first CR was 6.5 months that was taken as a reference point in landmark analysis of patients in whom allo-BSCT was not performed. Landmark analysis showed that in AML patients of favorable prognosis group allo-BSCT does not significantly reduce the probability of relapse (0 and 36%) and does not influence RFS (33 and 64%). In patients of border-line and poor prognosis allo-BSCT significantly reduces relapse probability (26 and 66%; 20 and 100%) and significantly increases a 7-year RFS (68.7 and 30%; 45.6 and 0%). Allo-BSCT also results in significant RFS increase and reduces the probability of relapse (25 and 78%) in patients in whom CR was achieved only after the second induction course. At the same time allo-BSCT does not influence patients who achieved CR after the first treatment course: 55 and 50%. Conclusion. Multivariate analysis showed that cytogenetic risk group (HR=2.3), time of CR achievement (HR=2.9), and allo-BSCT transplantation (HR=0.16) are independent factors for disease relapse prognosis after achieving CR. |
| اللغة: | Russian |
| تدمد: | 2309-5342 0040-3660 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::24b9b27f7ede5b9d8b26e26e70442917Test https://ter-arkhiv.ru/0040-3660/article/viewFile/32755/pdfTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....24b9b27f7ede5b9d8b26e26e70442917 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 23095342 00403660 |
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