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@ARTICLE{Wattad:124418,
author = {M. Wattad and D. Weber and K. Döhner and J. Krauter and V.
I. Gaidzik and P. Paschka and M. Heuser and F. Thol and T.
Kindler and M. Lübbert and H. R. Salih and A. Kündgen and
H.-A. Horst and P. Brossart and K. Götze and D. Nachbaur
and C.-H. Köhne and M. Ringhoffer and G. Wulf and G. Held
and H. Salwender and A. Benner$^*$ and A. Ganser and H.
Döhner and R. Schlenk},
title = {{I}mpact of salvage regimens on response and overall
survival in acute myeloid leukemia with induction failure.},
journal = {Leukemia},
volume = {31},
number = {6},
issn = {1476-5551},
address = {Basingstoke},
publisher = {Nature Publ. Group},
reportid = {DKFZ-2017-01295},
pages = {1306 - 1313},
year = {2017},
abstract = {We 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.},
cin = {C060},
ddc = {610},
cid = {I:(DE-He78)C060-20160331},
pnm = {313 - Cancer risk factors and prevention (POF3-313)},
pid = {G:(DE-HGF)POF3-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:28138160},
doi = {10.1038/leu.2017.23},
url = {https://inrepo02.dkfz.de/record/124418},
}