AML refractory to primary induction with Ida-FLAG has a poor clinical outcome Academic Article uri icon

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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.

authors

  • Kavanagh, Simon
  • Heath, Emily
  • Hurren, Rose
  • Gronda, Marcela
  • Barghout, Samir H
  • Liyanage, Sanduni U
  • Siriwardena, Thirushi P
  • Claudio, Jaime
  • Zhang, Tong
  • Sukhai, Mahadeo
  • Stockley, Tracy L
  • Kamel-Reid, Suzanne
  • Rostom, Amr
  • Lutynski, Andrzej
  • Khalif, Dina
  • Rydlewski, Anna
  • Chan, Steven M
  • Gupta, Vikas
  • Maze, Dawn
  • Sibai, Hassan
  • Schuh, Andre C
  • Yee, Karen
  • Minden, Mark D
  • Schimmer, Aaron D

publication date

  • May 2018

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