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Dose-enhanced combined priming regimens for refractory acute myeloid leukemia and middle-and-high-risk myelodysplastic syndrome: a single-center, retrospective cohort study.

Ma X, Wang J, Xu Y, Zhang W, Liu J, Cao X, He A, Wang F, Gu L, Lei B, Wang J - Onco Targets Ther (2016)

Bottom Line: However, although survival advantages were observed in the first year, the new regimens did not significantly improve 3-year overall survival (P>0.05).The rate of non-hematological side effects did not differ significantly between treatment regimens (P>0.05).Both RR and B7.1 expression were significantly higher in patients with AML-M2 and M5 (P<0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.

ABSTRACT

Objective: To assess chemotherapeutic regimens for refractory acute myeloid leukemia (AML) and middle-and-high-risk myelodysplastic syndrome (MDS).

Methods: Between 2004 and 2014, 44 patients with refractory AML and 36 patients with MDS were treated with new priming regimens (CHAG, CHTG, CHMG, or CTMG), and 77 patients with refractory AML and 52 patients with MDS were treated with conventional priming regimens (CHG or CAG). This was a single-center retrospective analysis of remission, adverse event, mortality, and survival. The capacity of clinical features (including the expression of co-stimulatory molecule B7.1 on tumor cells) to influence survival was assessed by multivariate Cox regression.

Results: Complete and partial remission rates (RRs) were significantly higher in AML patients treated with new regimens compared to conventional ones (68.2% vs 13.6%, P<0.05). Complete and partial remission were also significantly higher in patients with MDS treated with new regimens (55.6% vs 19.4%, P<0.05). However, although survival advantages were observed in the first year, the new regimens did not significantly improve 3-year overall survival (P>0.05). Patients administered the new regimens experienced more severe and sustained myelosuppression (P<0.05), but no severe adverse events or treatment-related deaths were observed. The rate of non-hematological side effects did not differ significantly between treatment regimens (P>0.05). Both RR and B7.1 expression were significantly higher in patients with AML-M2 and M5 (P<0.05).

Conclusion: The new priming regimens improved the RR, lowered the recurrence rate, and improved survival in AML and middle-and-high-risk MDS, without significantly increasing adverse events.

No MeSH data available.


Related in: MedlinePlus

Comparison of the complete remission rate in refractory AML (A) and middle-and-high-risk MDS (B) patients administered new and conventional priming regimens.Abbreviations: CR, complete remission; AML, acute myeloid leukemia; MDS, myelodysplastic syndrome.
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f2-ott-9-3661: Comparison of the complete remission rate in refractory AML (A) and middle-and-high-risk MDS (B) patients administered new and conventional priming regimens.Abbreviations: CR, complete remission; AML, acute myeloid leukemia; MDS, myelodysplastic syndrome.

Mentions: Response rates were assessed after two courses of chemotherapy. In patients with refractory AML, the RR and CR and PR rates were significantly higher in patients administered the new priming regimens (36/44 [81.8%], 30/44 [68.2%], and 6/44 [13.6%], respectively) than in patients administered conventional priming regimens (47/77 [61.0%], 40/77 [52.0%], and 7/77 [9.1%], respectively) (RR, P=0.018) (Figures 1A, 2A, and 3A). The rates in the AML-M2 (15/17) and AML-M5 (14/16) subgroups were significantly higher than in the other AML subgroups (P<0.05).


Dose-enhanced combined priming regimens for refractory acute myeloid leukemia and middle-and-high-risk myelodysplastic syndrome: a single-center, retrospective cohort study.

Ma X, Wang J, Xu Y, Zhang W, Liu J, Cao X, He A, Wang F, Gu L, Lei B, Wang J - Onco Targets Ther (2016)

Comparison of the complete remission rate in refractory AML (A) and middle-and-high-risk MDS (B) patients administered new and conventional priming regimens.Abbreviations: CR, complete remission; AML, acute myeloid leukemia; MDS, myelodysplastic syndrome.
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4920259&req=5

f2-ott-9-3661: Comparison of the complete remission rate in refractory AML (A) and middle-and-high-risk MDS (B) patients administered new and conventional priming regimens.Abbreviations: CR, complete remission; AML, acute myeloid leukemia; MDS, myelodysplastic syndrome.
Mentions: Response rates were assessed after two courses of chemotherapy. In patients with refractory AML, the RR and CR and PR rates were significantly higher in patients administered the new priming regimens (36/44 [81.8%], 30/44 [68.2%], and 6/44 [13.6%], respectively) than in patients administered conventional priming regimens (47/77 [61.0%], 40/77 [52.0%], and 7/77 [9.1%], respectively) (RR, P=0.018) (Figures 1A, 2A, and 3A). The rates in the AML-M2 (15/17) and AML-M5 (14/16) subgroups were significantly higher than in the other AML subgroups (P<0.05).

Bottom Line: However, although survival advantages were observed in the first year, the new regimens did not significantly improve 3-year overall survival (P>0.05).The rate of non-hematological side effects did not differ significantly between treatment regimens (P>0.05).Both RR and B7.1 expression were significantly higher in patients with AML-M2 and M5 (P<0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.

ABSTRACT

Objective: To assess chemotherapeutic regimens for refractory acute myeloid leukemia (AML) and middle-and-high-risk myelodysplastic syndrome (MDS).

Methods: Between 2004 and 2014, 44 patients with refractory AML and 36 patients with MDS were treated with new priming regimens (CHAG, CHTG, CHMG, or CTMG), and 77 patients with refractory AML and 52 patients with MDS were treated with conventional priming regimens (CHG or CAG). This was a single-center retrospective analysis of remission, adverse event, mortality, and survival. The capacity of clinical features (including the expression of co-stimulatory molecule B7.1 on tumor cells) to influence survival was assessed by multivariate Cox regression.

Results: Complete and partial remission rates (RRs) were significantly higher in AML patients treated with new regimens compared to conventional ones (68.2% vs 13.6%, P<0.05). Complete and partial remission were also significantly higher in patients with MDS treated with new regimens (55.6% vs 19.4%, P<0.05). However, although survival advantages were observed in the first year, the new regimens did not significantly improve 3-year overall survival (P>0.05). Patients administered the new regimens experienced more severe and sustained myelosuppression (P<0.05), but no severe adverse events or treatment-related deaths were observed. The rate of non-hematological side effects did not differ significantly between treatment regimens (P>0.05). Both RR and B7.1 expression were significantly higher in patients with AML-M2 and M5 (P<0.05).

Conclusion: The new priming regimens improved the RR, lowered the recurrence rate, and improved survival in AML and middle-and-high-risk MDS, without significantly increasing adverse events.

No MeSH data available.


Related in: MedlinePlus