A prognostic model for survival after salvage treatment with FLAG-Ida plus /- gemtuzumab-ozogamicine in adult patients with refractory/relapsed acute myeloid leukaemia
Por:
Bergua, J, Montesinos, P, Martinez-Cuadron, D, Fernandez P, Serrano, J, Sayas, M, Prieto-Fernandez, J, Garcia, R, Garcia-Huerta, A, Barrios, M, Benavente, C, Perez-Encinas, M, Simiele, A, Rodriguez-Macias, G, Herrera-Puente, P, Rodriguez-Veiga, R, Martinez-Sanchez, M, Amador-Barciela, M, Riaza-Grau, R, Sanz, M and PETHEMA Grp
Publicada:
1 sep 2016
Categoría:
Hematology
Resumen:
The combination of fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor (FLAG-Ida) is widely used in relapsed/refractory acute myeloid leukaemia (AML). We retrospectively analysed the results of 259 adult AML patients treated as first salvage with FLAG-Ida or FLAG-Ida plus Gentuzumab-Ozogamicin (FLAGO-Ida) of the Programa Espanol de Tratamientos en Hematologia (PETHEMA) database, developing a prognostic score system of survival in this setting (SALFLAGE score). Overall, 221 patients received FLAG-Ida and 38 FLAGO-Ida; 92 were older than 60years. The complete remission (CR)/CR with incomplete blood count recovery (CRi) rate was 51%, with 9% of induction deaths. Three covariates were associated with lower CR/CRi: high-risk cytogenetics and t(8;21) at diagnosis, no previous allogeneic stem cell transplantation (allo-SCT) and relapse-free interval <1year. Allo-SCT was performed in second CR in 60 patients (23%). The median overall survival (OS) of the entire cohort was 07years, with 22% OS at 5-years. Four independent variables were used to construct the score: cytogenetics, FLT3-internal tandem duplication, length of relapse-free interval and previous allo-SCT. Using this stratification system, three groups were defined: favourable (26% of patients), intermediate (29%) and poor-risk (45%), with an expected 5-year OS of 52%, 26% and 7%, respectively. The SALFLAGE score discriminated a subset of patients with an acceptable long-term outcome using FLAG-Ida/FLAGO-Ida regimen. The results of this retrospective analysis should be validated in independent external cohorts.
Filiaciones:
Bergua, J:
Hosp San Pedro de Alcantara, Dept Haematol, Caceres, Spain
Montesinos, P:
Univ Hosp La Fe, Dept Haematol, Valencia, Spain
Martinez-Cuadron, D:
Univ Hosp La Fe, Dept Haematol, Valencia, Spain
Fernandez P:
Gen Hosp Alicante, Dept Haematol, Alicante, Spain
Serrano, J:
Hosp Reina Sofia, Dept Haematol, Cordoba, Spain
:
Hosp Doctor Peset, Dept Haematol, Valencia, Spain
Prieto-Fernandez, J:
Hosp San Pedro de Alcantara, Dept Haematol, Caceres, Spain
:
Gen Hosp Castellon, Dept Haematol, Castellon de La Plana, Spain
Garcia-Huerta, A:
Hosp Cent Asturias, Dept Haematol, Oviedo, Spain
Barrios, M:
Hosp Carlos Haya, Dept Haematol, Malaga, Spain
Benavente, C:
Dept Haematol, Madrid, Spain
Perez-Encinas, M:
Clin Hosp, Dept Haematol, Santiago De Compostela, Spain
Simiele, A:
Hosp Povisa, Dept Haematol, Vigo, Spain
Rodriguez-Macias, G:
Hosp Gregorio Maranon, Dept Haematol, Madrid, Spain
Herrera-Puente, P:
Hosp Ramon & Cajal, Dept Haematol, Madrid, Spain
Rodriguez-Veiga, R:
Univ Hosp La Fe, Dept Haematol, Valencia, Spain
Martinez-Sanchez, M:
Hosp 12 Octubre, Dept Haematol, Madrid, Spain
Amador-Barciela, M:
Hosp Montecelo, Dept Haematol, Pontevedra, Spain
Riaza-Grau, R:
Hosp Severo Ochoa, Dept Haematol, Leganes, Spain
Sanz, M:
Univ Hosp La Fe, Dept Haematol, Valencia, Spain
Bronze
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