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- Title
Twenty five years of UK trials in acute myeloid leukaemia: what have we learned?
- Authors
Burnett, Alan K.; Hills, Robert K.; Russell, Nigel
- Abstract
An updated individual patient-based meta-analysis of the five adult trials (Hills I et al. i , [33]), to which AML15 and -16 contributed 67% of the patients, assessing the addition of GO to induction treatment suggested little difference, but possibly less toxicity with the 3 mg dose compared with 6 mg. While the high initial recruitment and response rate in younger patients has meant that more patients were available postinduction to enable robust questions to be asked, the same was not the case in older patients. It is therefore important to have a clear indication of the relapse risk for each patient, and what the prospects are of re-inducing a patient who relapses, which provides the option of transplant in CR2 if needed (Burnett I et al. i , [13]). In the AML17 trial patients with a high-risk score post course 1 or refractory disease (>15% blasts with < 50% blast reduction post course 1) or more recently an I FLT3 SP + sp /NPM1c SP - sp i genotype underwent treatment intensification post course 1 with the aim of identifying high-risk patients early and delivering more such patients to transplant in remission. In the current AML19 trial patients defined as high-risk in AML17 have been supplemented by patients who were standard risk post course 1 but found to have high-risk MRD post course 2, either by flow cytometry or patients lacking an I NPM1 i mutation (Freeman I et al. i , [25]) or by the real-time quantitative polymerase chain reaction (RQ-PCR) for I NMP1 i in the I NPM1 i -mutated AML with or without an I FLT3 i mutation (Ivey I et al. i , [34]).
- Subjects
UNITED Kingdom; LEUKEMIA; GRANULOCYTE-colony stimulating factor
- Publication
British Journal of Haematology, 2020, Vol 188, Issue 1, p86
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.16359