Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group
Abstract Given the heterogeneity of acute myeloid leukemia patients, it is necessary to identify patients considered fit for intensive therapy but who will perform poorly, and in whom alternative approaches deserve investigation. We analyzed 1034 fit adults ≤70 years intensively treated between 2012...
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2025-01-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-024-01205-5 |
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| author | Guadalupe Oñate Ana Garrido Montserrat Arnan Helena Pomares Ester Alonso Mar Tormo Marina Diaz-Beya Susana Vives Lurdes Zamora Antonia Sampol Rosa Coll Olga Salamero Marta Cervera Antoni Garcia Ferran Vall-Llovera Sara Garcia-Avila Joan Bargay Xavier Ortin Eva Iranzo Francisca Guijarro Marta Pratcorona Josep F. Nomdedeu Jordi Esteve Jorge Sierra |
| author_facet | Guadalupe Oñate Ana Garrido Montserrat Arnan Helena Pomares Ester Alonso Mar Tormo Marina Diaz-Beya Susana Vives Lurdes Zamora Antonia Sampol Rosa Coll Olga Salamero Marta Cervera Antoni Garcia Ferran Vall-Llovera Sara Garcia-Avila Joan Bargay Xavier Ortin Eva Iranzo Francisca Guijarro Marta Pratcorona Josep F. Nomdedeu Jordi Esteve Jorge Sierra |
| author_sort | Guadalupe Oñate |
| collection | DOAJ |
| description | Abstract Given the heterogeneity of acute myeloid leukemia patients, it is necessary to identify patients considered fit for intensive therapy but who will perform poorly, and in whom alternative approaches deserve investigation. We analyzed 1034 fit adults ≤70 years intensively treated between 2012 and 2022 in the CETLAM group. Young adults ( ≤ 60 years) presented higher remission rates and improved survival than older adults above that age (CR 79% vs. 73%; p = 0.03 and 4-yr OS 53% vs. 33%; p < 0.001). Remission and survival outcomes varied among different genetic subsets. An especially adverse genetic group included complex, monosomal karyotype, TP53 alterations (deleted/mutated), and MECOMr. Transplant feasibility in this very adverse risk group was low, and OS and EFS at 4 years were 14% and 12%, in contrast to 70% and 57% in the favorable group and 38% and 32% in all other patients. We integrated clinical and genetic data into the Intensive Chemotherapy Score for AML (ICSA) with 6-risk categories with significantly different remission rates and OS, validated in another cohort of 581 AML patients from a previous CETLAM protocol. In summary, we identified groups of fit patients that benefit differently from an intensive approach which may be helpful in future treatment decisions. |
| format | Article |
| id | doaj-art-901833f00e0a4fa4b80e008d167d7e37 |
| institution | Kabale University |
| issn | 2044-5385 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj-art-901833f00e0a4fa4b80e008d167d7e372025-01-12T12:08:50ZengNature Publishing GroupBlood Cancer Journal2044-53852025-01-0115111110.1038/s41408-024-01205-5Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM GroupGuadalupe Oñate0Ana Garrido1Montserrat Arnan2Helena Pomares3Ester Alonso4Mar Tormo5Marina Diaz-Beya6Susana Vives7Lurdes Zamora8Antonia Sampol9Rosa Coll10Olga Salamero11Marta Cervera12Antoni Garcia13Ferran Vall-Llovera14Sara Garcia-Avila15Joan Bargay16Xavier Ortin17Eva Iranzo18Francisca Guijarro19Marta Pratcorona20Josep F. Nomdedeu21Jordi Esteve22Jorge Sierra23Hospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaHospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaInstitut Catala d’Oncologia, Hospital Duran i Reynals, Institut d’Investigacio Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, University of BarcelonaInstitut Catala d’Oncologia, Hospital Duran i Reynals, Institut d’Investigacio Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, University of BarcelonaInstitut Catala d’Oncologia, Hospital Duran i Reynals, Institut d’Investigacio Biomèdica de Bellvitge (IDIBELL), L’Hospitalet de Llobregat, University of BarcelonaHospital Clinico Universitario, Biomedical Research Institute INCLIVAHospital Clinic. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of BarcelonaInstitut Catala d’Oncologia, Hospital Germans Trias i Pujol. Josep Carreras Leukemia Research Institute, Badalona, Universitat Autonoma of BarcelonaInstitut Catala d’Oncologia, Hospital Germans Trias i Pujol. Josep Carreras Leukemia Research Institute, Badalona, Universitat Autonoma of BarcelonaHospital Universitari Son EspasesInstitut Català d’Oncologia, Hospital Josep TruetaHospital Universitari Vall d’Hebron and Institute of Oncology (VHIO), Universitat Autonoma of BarcelonaInstitut Catala d’Oncologia, Hospital Joan XXIIIHospital Universitari Arnau de VilanovaHospital Universitari Mutua de TerrassaHospital del MarHospital Son LlatzerHospital Verge de la CintaHospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaHospital Clinic. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of BarcelonaHospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaHospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaHospital Clinic. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of BarcelonaHospital de la Santa Creu i Sant Pau. Institut d’investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of BarcelonaAbstract Given the heterogeneity of acute myeloid leukemia patients, it is necessary to identify patients considered fit for intensive therapy but who will perform poorly, and in whom alternative approaches deserve investigation. We analyzed 1034 fit adults ≤70 years intensively treated between 2012 and 2022 in the CETLAM group. Young adults ( ≤ 60 years) presented higher remission rates and improved survival than older adults above that age (CR 79% vs. 73%; p = 0.03 and 4-yr OS 53% vs. 33%; p < 0.001). Remission and survival outcomes varied among different genetic subsets. An especially adverse genetic group included complex, monosomal karyotype, TP53 alterations (deleted/mutated), and MECOMr. Transplant feasibility in this very adverse risk group was low, and OS and EFS at 4 years were 14% and 12%, in contrast to 70% and 57% in the favorable group and 38% and 32% in all other patients. We integrated clinical and genetic data into the Intensive Chemotherapy Score for AML (ICSA) with 6-risk categories with significantly different remission rates and OS, validated in another cohort of 581 AML patients from a previous CETLAM protocol. In summary, we identified groups of fit patients that benefit differently from an intensive approach which may be helpful in future treatment decisions.https://doi.org/10.1038/s41408-024-01205-5 |
| spellingShingle | Guadalupe Oñate Ana Garrido Montserrat Arnan Helena Pomares Ester Alonso Mar Tormo Marina Diaz-Beya Susana Vives Lurdes Zamora Antonia Sampol Rosa Coll Olga Salamero Marta Cervera Antoni Garcia Ferran Vall-Llovera Sara Garcia-Avila Joan Bargay Xavier Ortin Eva Iranzo Francisca Guijarro Marta Pratcorona Josep F. Nomdedeu Jordi Esteve Jorge Sierra Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group Blood Cancer Journal |
| title | Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group |
| title_full | Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group |
| title_fullStr | Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group |
| title_full_unstemmed | Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group |
| title_short | Diverse real-life outcomes after intensive risk-adapted therapy for 1034 AML patients from the CETLAM Group |
| title_sort | diverse real life outcomes after intensive risk adapted therapy for 1034 aml patients from the cetlam group |
| url | https://doi.org/10.1038/s41408-024-01205-5 |
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