TY - JOUR
T1 - Re-induction chemotherapy using FLAG–mitoxantrone for adult patients with relapsed acute leukemia
T2 - a single-center experience from United Arab Emirates
AU - Hassan, Inaam Bashir
AU - Kristensen, Jorgen
AU - Al Qawasmeh, Khalid
AU - Alam, Arif
N1 - Publisher Copyright:
© 2018, The Japanese Society of Hematology.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - We studied the outcome of 47 adult patients with relapsed acute leukaemia (AML = 25 and ALL = 22) treated with FLAG–mitoxantrone regimen. Median time to relapse was 10.7 months (range 1.9–27.7). Complete remission (CR2) was 60.1% which was significantly more frequent in ALL compared to AML (P = 0.049). WBC count < 100 × 109/L at initial diagnosis and time to relapse > 1 year were significantly predictor for CR2 in AML (P = 0.005 for both). Induction death was significantly higher in ALL compared to AML (P = 0.039). Median follow-up was 4.0 months (0.9–119.8) for AML and 2.1 months (range 0.6–118.1) for ALL. Nine patients underwent allogeneic stem-cell transplantation (allo-SCT). Estimated overall survival (OS) at 12 and 18 months was 60.5 and 34.6%, respectively, for AML, and 39.9 and 29.9%, respectively, for ALL. For AML patients failure to achieve CR, WBC count at initial diagnosis > 5 × 109/L and poor cytogenetic risk group was significant predictors of poor OS (P = 0.010, P = 0.025, and P = 0.015, respectively). For ALL patients failure to achieve of CR, WBC count at relapse < 5 × 109/L (CR patients) and lack of any type of consolidation therapy were significant predictor of poor OS (P < 0.001, P = 0.008, P = 0.008, respectively).
AB - We studied the outcome of 47 adult patients with relapsed acute leukaemia (AML = 25 and ALL = 22) treated with FLAG–mitoxantrone regimen. Median time to relapse was 10.7 months (range 1.9–27.7). Complete remission (CR2) was 60.1% which was significantly more frequent in ALL compared to AML (P = 0.049). WBC count < 100 × 109/L at initial diagnosis and time to relapse > 1 year were significantly predictor for CR2 in AML (P = 0.005 for both). Induction death was significantly higher in ALL compared to AML (P = 0.039). Median follow-up was 4.0 months (0.9–119.8) for AML and 2.1 months (range 0.6–118.1) for ALL. Nine patients underwent allogeneic stem-cell transplantation (allo-SCT). Estimated overall survival (OS) at 12 and 18 months was 60.5 and 34.6%, respectively, for AML, and 39.9 and 29.9%, respectively, for ALL. For AML patients failure to achieve CR, WBC count at initial diagnosis > 5 × 109/L and poor cytogenetic risk group was significant predictors of poor OS (P = 0.010, P = 0.025, and P = 0.015, respectively). For ALL patients failure to achieve of CR, WBC count at relapse < 5 × 109/L (CR patients) and lack of any type of consolidation therapy were significant predictor of poor OS (P < 0.001, P = 0.008, P = 0.008, respectively).
KW - ALL
KW - AML
KW - FLAG–mitoxantrone
KW - Re-induction
KW - Relapse
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U2 - 10.1007/s12185-018-2478-3
DO - 10.1007/s12185-018-2478-3
M3 - Article
C2 - 29951735
AN - SCOPUS:85049109170
SN - 0925-5710
VL - 108
SP - 390
EP - 401
JO - International Journal of Hematology
JF - International Journal of Hematology
IS - 4
ER -