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000124418 0247_ $$2doi$$a10.1038/leu.2017.23
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000124418 1001_ $$aWattad, M.$$b0
000124418 245__ $$aImpact of salvage regimens on response and overall survival in acute myeloid leukemia with induction failure.
000124418 260__ $$aBasingstoke$$bNature Publ. Group$$c2017
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000124418 520__ $$aWe evaluated the impact of salvage regimens and allogeneic hematopoietic cell transplantation (allo-HCT) in acute myeloid leukemia (AML) with induction failure. Between 1993 and 2009, 3324 patients with newly diagnosed AML were enrolled in 5 prospective treatment trials of the German-Austrian AML Study Group. After first induction therapy with idarubicin, cytarabine and etoposide (ICE), 845 patients had refractory disease. In addition, 180 patients, although responding to first induction, relapsed after second induction therapy. Of the 1025 patients with induction failure, 875 (median age 55 years) received intensive salvage therapy: 7+3-based (n=59), high-dose cytarabine combined with mitoxantrone (HAM; n=150), with all-trans retinoic acid (A; A-HAM) (n=247), with gemtuzumab ozogamicin and A (GO; GO-A-HAM) (n=140), other intensive regimens (n=165), experimental treatment (n=27) and direct allo-HCT (n=87). In patients receiving intensive salvage chemotherapy (n=761), response (complete remission/complete remission with incomplete hematological recovery (CR/CRi)) was associated with GO-A-HAM treatment (odds ratio (OR), 1.93; P=0.002), high-risk cytogenetics (OR, 0.62; P=0.006) and age (OR for a 10-year difference, 0.75; P<0.0001). Better survival probabilities were seen in an extended Cox regression model with time-dependent covariables in patients responding to salvage therapy (P<0.0001) and having the possibility to perform an allo-HCT (P<0.0001). FLT3 internal tandem duplication, mutated IDH1 and adverse cytogenetics were unfavorable factors for survival.
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000124418 7001_ $$aWeber, D.$$b1
000124418 7001_ $$aDöhner, K.$$b2
000124418 7001_ $$aKrauter, J.$$b3
000124418 7001_ $$aGaidzik, V. I.$$b4
000124418 7001_ $$aPaschka, P.$$b5
000124418 7001_ $$aHeuser, M.$$b6
000124418 7001_ $$aThol, F.$$b7
000124418 7001_ $$aKindler, T.$$b8
000124418 7001_ $$aLübbert, M.$$b9
000124418 7001_ $$aSalih, H. R.$$b10
000124418 7001_ $$aKündgen, A.$$b11
000124418 7001_ $$aHorst, H-A$$b12
000124418 7001_ $$aBrossart, P.$$b13
000124418 7001_ $$aGötze, K.$$b14
000124418 7001_ $$aNachbaur, D.$$b15
000124418 7001_ $$aKöhne, C-H$$b16
000124418 7001_ $$aRinghoffer, M.$$b17
000124418 7001_ $$aWulf, G.$$b18
000124418 7001_ $$aHeld, G.$$b19
000124418 7001_ $$aSalwender, H.$$b20
000124418 7001_ $$0P:(DE-He78)e15dfa1260625c69d6690a197392a994$$aBenner, A.$$b21
000124418 7001_ $$aGanser, A.$$b22
000124418 7001_ $$aDöhner, H.$$b23
000124418 7001_ $$0P:(DE-He78)d8a0e60e5e095f3161ee0de3712409bc$$aSchlenk, Richard$$b24
000124418 773__ $$0PERI:(DE-600)2008023-2$$a10.1038/leu.2017.23$$gVol. 31, no. 6, p. 1306 - 1313$$n6$$p1306 - 1313$$tLeukemia$$v31$$x1476-5551$$y2017
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000124418 9141_ $$y2017
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