; Weber, Daniela ; Fiedler, Walter ; Salih, Helmut R. ; Wulf, Gerald ; Salwender, Hans ; Schroeder, Thomas ; Kindler, Thomas ; Lübbert, Michael ; Wolf, Dominik ; Westermann, Jörg ; Kraemer, Doris ; Götze, Katharina S. ; Horst, Heinz-August ; Krauter, Jürgen ; Girschikofsky, Michael ; Ringhoffer, Mark ; Südhoff, Thomas ; Held, Gerhard ; Derigs, Hans-Günter ; Schroers, Roland ; Greil, Richard ; Grießhammer, Martin ; Lange, Elisabeth ; Burchardt, Alexander ; Martens, Uwe ; Hertenstein, Bernd ; Marretta, Lore ; Heuser, Michael ; Thol, Felicitas ; Gaidzik, Verena I. ; Herr, Wolfgang ; Krzykalla, Julia ; Benner, Axel ; Döhner, Konstanze ; Ganser, Arnold ; Paschka, Peter ; Döhner, Hartmut | Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Blood | ||||
| Verlag: | AMER SOC HEMATOLOGY | ||||
| Ort der Veröffentlichung: | WASHINGTON | ||||
| Band: | 133 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 8 | ||||
| Seitenbereich: | S. 840-851 | ||||
| Datum: | 2019 | ||||
| Institutionen: | Medizin > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) | ||||
| Identifikationsnummer: |
| ||||
| Stichwörter / Keywords: | TRANS-RETINOIC ACID; INTERNAL TANDEM DUPLICATION; NPM1 MUTATIONS; ADULT PATIENTS; AML; IMPACT; OLDER; TRANSPLANTATION; RECOMMENDATIONS; CLASSIFICATION; | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 48970 |
Zusammenfassung
Patients with acute myeloid leukemia (AML) and a FLT3 internal tandem duplication (ITD) have poor outcomes to current treatment. A phase 2 hypothesis-generating trial was conducted to determine whether the addition of the multitargeted kinase inhibitor midostaurin to intensive chemotherapy followed by allogeneic hematopoietic cell transplantation (alloHCT) and single-agent maintenance therapy of ...

Zusammenfassung
Patients with acute myeloid leukemia (AML) and a FLT3 internal tandem duplication (ITD) have poor outcomes to current treatment. A phase 2 hypothesis-generating trial was conducted to determine whether the addition of the multitargeted kinase inhibitor midostaurin to intensive chemotherapy followed by allogeneic hematopoietic cell transplantation (alloHCT) and single-agent maintenance therapy of 12 months is feasible and favorably influences event-free survival (EFS) compared with historical controls. Patients 18 to 70 years of age with newly diagnosed AML and centrally confirmed FLT3-ITD were eligible: 284 patients were treated, including 198 younger (18-60 years) and 86 older (61-70 years) patients. Complete remission (CR) rate, including CR with incomplete hematological recovery (CRi) after induction therapy, was 76.4% (younger, 75.8%; older, 77.9%). The majority of patients in CR/CRi proceeded to alloHCT (72.4%). Maintenance therapy was started in 97 patients (34%): 75 after alloHCT and 22 after consolidation with high-dose cytarabine (HiDAC). Median time receiving maintenance therapy was 9 months after alloHCT and 10.5 months after HiDAC; premature termination was mainly a result of nonrelapse causes (gastrointestinal toxicity and infections). EFS and overall survival at 2 years were 39% (95% confidence interval [CI], 33%-47%) and 34% (95% CI, 24%-47%) and 53% (95% CI, 46%-61%) and 46% (95% CI, 35%-59%) in younger and older patients, respectively. EFS was evaluated in comparison with 415 historical controls treated within 5 prospective trials. Propensity score-weighted analysis revealed a significant improvement of EFS by midostaurin (hazard ratio [HR], 0.58; 95% CI, 0.48-0.70; P <.001) overall and in older patients (HR, 0.42; 95% CI, 0.29-0.61). The study was registered at www.clinicaltrials.gov as # NCT01477606.
Metadaten zuletzt geändert: 03 Sep 2021 10:04
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