Acute Myeloid Leukemias: 10-Year Therapy Experience

Ol’ga Yur’evna Baranova, A.S. Antipova, O.D. Zakharov, N.A. Falaleeva, G.I. Kaletin, A.D. Shirin, G.R. Arakelyan, N.N. Tupitsyn, M.A. Frenkel’, N.A. Kupryshina, T.N. Obukhova, E.V. Domracheva, V.B. Larionova, E.V. Ogorodnikova, E.A. Osmanov,

DOI:

https://doi.org/10.21320/2500-2139-2015-8-3-287-301

Objective. To assess treatment outcomes of 132 patients with acute myeloid leukemia (AML) treated in hematology department of the N.N. Blokhin Russian Cancer Research Center over the period from January, 2003, till November, 2014.

Methods. 106 patients with primary AML and 26 patients with secondary AML and AML arising from MDS were enrolled in this study. Median age was 43.5 years (varied from 15 to 82). The study design provided 1 cycle of remission induction according to the 3+7+7 scheme (idarubicin 12 mg/m2 on days 1–3, cytarabine 100 mg/m2 every 12 h on days 1–7, etoposide 75 mg/m2 on days 1–7), 2 cycles of consolidation according to the HAI scheme (cytarabine 3 g/m2 on days 1, 3, 5; idarubicin 10 mg/m2 on days 2, 4), and 6 cycles of maintenance treatment according the 1+5+5 scheme for patients younger than 60 years (cytarabine 100 mg/m2 every 12 h on days 1–5, idarubicin 15 mg/m2 on day 1, etoposide 75 mg/m2 on days 1–5). The treatment protocol for patients aged 60–65 did not include etoposide, and the cytarabine dose was reduced to 1 g/m2 at the remission consolidation stage.

Results. The analysis of treatment efficacy in 71 patients younger than 60 years with primary AML demonstrated that the percentage of complete remissions (CR) was 77.5 %. In 41 (74.5 %) patients the CR was achieved after the 1st induction cycle. The 5-year overall survival (OS) and relapse-free survival (RFS) rates were 43 % and 52 %, respectively. In the favorable cytogenetic risk group, the CR rate was 90 %, 5-year ОS and RFS were 65 % and 100 %, respectively; in the intermediate cytogenetic risk group these parameters were 90.5 %, 45 %, and 48 %, respectively. In the high risk group, CR was achieved in 36.4 % patients achieved; the resistant disease was observed in 63.6 % of cases, 2-years ОS and DFS rates were 16 % and 0 %, respectively. Among patients aged 60–65 years receiving intensified consolidation therapy, the CR rate was 61.5 %, the resistant disease was observed in 23.1 % of cases. The early mortality rate was 15.4 %, and the 3-year ОS and DFS rates were 14 % and 50 %, respectively.

Conclusion. The treatment program with intensified consolidation demonstrated high long-term survival rates in patients with primary AML younger than 60 years. The best results were obtained in the favorable cytogenetic risk group. Management of patients over 60 years of age and patients with AML in high-risk cytogenetic group is still a challenge.

  • Ol’ga Yur’evna Baranova N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • A.S. Antipova N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • O.D. Zakharov Municipal Outpatient’s Hospital No. 11 under the Department of Healthcare of Moscow, 14 Kravchenko str., Moscow, Russian Federation, 119331 ; ГБУЗ «Городская поликлиника № 11 Департамента здравоохранения г. Москвы», ул. Кравченко, д. 14, Москва, Российская Федерация, 119331
  • N.A. Falaleeva N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • G.I. Kaletin N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • A.D. Shirin N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • G.R. Arakelyan N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • N.N. Tupitsyn N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • M.A. Frenkel’ N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • N.A. Kupryshina N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • T.N. Obukhova Hematology Research Center under the Ministry of Health of the Russian Federation, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «Гематологический научный центр» Минздрава России, Новый Зыковский пр-д, д. 4а, Москва, Российская Федерация, 125167
  • E.V. Domracheva Hematology Research Center under the Ministry of Health of the Russian Federation, 4а Novyi Zykovskii pr-d, Moscow, Russian Federation, 125167 ; ФГБУ «Гематологический научный центр» Минздрава России, Новый Зыковский пр-д, д. 4а, Москва, Российская Федерация, 125167
  • V.B. Larionova N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • E.V. Ogorodnikova N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
  • E.A. Osmanov N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478 ; ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478
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Keywords:

acute myeloid leukemia, high doses cytarabine

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  • Ol’ga Yur’evna Baranova, N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478, ФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина», Каширское ш., д. 24, Москва, Российская Федерация, 115478

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01.07.2015

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Vol. 8 No. 3 (2015)
MYELOID MALIGNANCIES

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Baranova O.Y., Antipova A.S., Zakharov O.D., et al. Acute Myeloid Leukemias: 10-Year Therapy Experience. Clinical Oncohematology. 2015;8(3):287–301. doi:10.21320/2500-2139-2015-8-3-287-301.

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