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A prognostic model for survival after salvage treatment with FLAG-Ida plus /- gemtuzumab-ozogamicine in adult patients with refractory/relapsed acute myeloid leukaemia

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Bergua JM
  • Fernández-Abellán P
  • Serrano J
  • Sayas MJ
  • Prieto-Fernandez J
  • García R
  • García-Huerta AJ
  • Barrios M
  • Benavente C
  • Pérez-Encinas M
  • Simiele A
  • Rodríguez-Macias G
  • Herrera-Puente P
  • Martínez-Sánchez MP
  • Amador-Barciela ML
  • Riaza-Grau R
  • PETHEMA group

Grupos

Abstract

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.

Datos de la publicación

ISSN/ISSNe:
0007-1048, 1365-2141

BRITISH JOURNAL OF HAEMATOLOGY  WILEY

Tipo:
Article
Páginas:
700-710
PubMed:
27118319
Factor de Impacto:
2,086 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 45

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Keywords

  • relapsed-refractory acute myeloid leukaemia; salvage treatment; FLAG-Ida; prognostic factors; genetic risk

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