The addition of daunorubicin to imatinib mesylate in combination with cytarabine improves the response rate and the survival of patients with myeloid blast crisis chronic myelogenous leukemia (AFR01 study).

Abstract:

BACKGROUND:The median survival of patients with chronic myelogenous leukemia in myeloid blast crisis (MBC-CML) is poor even for patients treated with tyrosine kinase inhibitors (TKIs). DESIGN AND METHODS:We conducted a dose-escalating study of daunorubicin combined to fixed doses of IM (imatinib mesylate, 600 mg/d) and cytarabine (200 mg/d for 7 days), followed by hematopoietic stem cell transplantation or maintenance therapy with single-agent IM in patients with MBC-CML at onset or after failure of therapy excluding TKIs. RESULTS:Thirty-six patients were evaluated. Median follow-up is 6.1 years. Daunorubicin was escaladed up to 45 mg/m(2)/d 3 days. Twenty eight patients (77.7%) had hematologic response including 20 patients (55.5%) in complete hematologic response (CHR). Patients who received daunorubicin at 30-45 mg/m(2)/d had higher CHR rates compared to other patients. Median overall survival was 16 months. Overall survival in patients with hematological response was 35.4 months. Better results were observed in patients diagnosed with MBC-CML at onset. CONCLUSIONS:The combination of IM with a standard "3+7" regiment was well tolerated and provided a high response rate. More than 55% of the patients achieved CHR and hematopoietic stem cell transplantation (SCT) was feasible in half of the cases. This trial was registered at www.clinicaltrials.gov as # NCT00219765.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Deau B,Nicolini FE,Guilhot J,Huguet F,Guerci A,Legros L,Pautas C,Berthou C,Guyotat D,Cony-Makhoul P,Gardembas M,Michallet M,Hayette S,Cayuela JM,Weiss IR,Réa D,Castaigne S,Mahon FX,Guilhot F,Rousselot P

doi

10.1016/j.leukres.2010.11.004

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

777-82

issue

6

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(10)00533-3

journal_volume

35

pub_type

临床试验,杂志文章,多中心研究
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  • Dimethyl sulfoxide potentiates death receptor-mediated apoptosis in the human myeloid leukemia U937 cell line through enhancement of mitochondrial membrane depolarization.

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  • Intracellular accumulation of cytosine arabinoside in murine normal and neoplastic lymphocytes following their exposure to sodium 2-mercaptoethanesulphonate.

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    pub_type: 杂志文章,评审

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