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037 _ _ |a DKFZ-2020-00805
041 _ _ |a eng
082 _ _ |a 610
100 1 _ |a Schlenk, Richard F
|b 0
245 _ _ |a Gemtuzumab Ozogamicin in NPM1-Mutated Acute Myeloid Leukemia: Early Results From the Prospective Randomized AMLSG 09-09 Phase III Study.
260 _ _ |a Alexandria, Va.
|c 2020
|b American Society of Clinical Oncology
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520 _ _ |a High CD33 expression in acute myeloid leukemia (AML) with mutated NPM1 provides a rationale for the evaluation of gemtuzumab ozogamicin (GO) in this AML entity. We conducted a randomized trial to evaluate GO in combination with intensive induction and consolidation therapy in NPM1-mutated AML.Between May 2010 and September 2017, patients ≥ 18 years old and considered eligible for intensive therapy were randomly assigned up front for induction therapy with idarubicin, cytarabine, etoposide, and all-trans-retinoic acid with or without GO. The early (P = .02) primary end point of event-free survival (EFS) was evaluated 6 months after completion of patient recruitment.Five hundred eighty-eight patients were randomly assigned (standard arm, n = 296; GO arm, n = 292). EFS in the GO arm was not significantly different compared with that in the standard arm (hazard ratio, 0.83; 95% CI, 0.65 to 1.04; P = .10). The early death rate during induction therapy was 10.3% in the GO arm and 5.7% in the standard arm (P = .05). Causes of death in both arms were mainly infections. The cumulative incidence of relapse (CIR) in patients achieving a complete remission (CR) or CR with incomplete hematologic recovery (CRi) was significantly reduced in the GO arm compared with the standard arm (P = .005), with no difference in the cumulative incidence of death (P = .80). Subgroup analysis revealed a significant beneficial effect of GO in female, younger (≤ 70 years), and FLT3 internal tandem duplication-negative patients with respect to EFS and CIR.The trial did not meet its early primary end point of EFS, mainly as a result of a higher early death rate in the GO arm. However, in patients achieving CR/CRi after induction therapy, significantly fewer relapses occurred in the GO compared with the standard arm.
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700 1 _ |a Paschka, Peter
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700 1 _ |a Krzykalla, Julia
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700 1 _ |a Weber, Daniela
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700 1 _ |a Kapp-Schwoerer, Silke
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700 1 _ |a Gaidzik, Verena I
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700 1 _ |a Leis, Claudia
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700 1 _ |a Fiedler, Walter
|b 7
700 1 _ |a Kindler, Thomas
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700 1 _ |a Schroeder, Thomas
|b 9
700 1 _ |a Mayer, Karin
|b 10
700 1 _ |a Lübbert, Michael
|b 11
700 1 _ |a Wattad, Mohammed
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700 1 _ |a Götze, Katharina
|b 13
700 1 _ |a Horst, Heinz A
|b 14
700 1 _ |a Koller, Elisabeth
|b 15
700 1 _ |a Wulf, Gerald
|b 16
700 1 _ |a Schleicher, Jan
|b 17
700 1 _ |a Bentz, Martin
|b 18
700 1 _ |a Greil, Richard
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700 1 _ |a Hertenstein, Bernd
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700 1 _ |a Krauter, Jürgen
|b 21
700 1 _ |a Martens, Uwe
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700 1 _ |a Nachbaur, David
|b 23
700 1 _ |a Abu Samra, Maisun
|b 24
700 1 _ |a Girschikofsky, Michael
|b 25
700 1 _ |a Basara, Nadezda
|b 26
700 1 _ |a Benner, Axel
|b 27
700 1 _ |a Thol, Felicitas
|b 28
700 1 _ |a Heuser, Michael
|b 29
700 1 _ |a Ganser, Arnold
|b 30
700 1 _ |a Döhner, Konstanze
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700 1 _ |a Döhner, Hartmut
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773 _ _ |a 10.1200/JCO.19.01406
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