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1.
Ann Hematol ; 2024 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-38884787

RESUMO

FLT3-ITD and NPM1 mutations are key to defining the genetic risk profile of acute myeloid leukemia (AML). We aimed to assess the prognostic features of the FLT3-ITD and NPM1 mutations in old and/or unfit individuals with AML treated with non-intensive therapies in the era before azacitidine-venetoclax approbation. The results of various non-intensive regimens were also compared. We conducted a retrospective analysis that included patients treated with different non-intensive regimens, between 2007 and 2020 from PETHEMA AML registry. We compiled 707 patients with a median age of 74 years and median follow-up time of 37.7 months. FLT3-ITD patients (N = 98) showed a non-significant difference in overall survival (OS) compared to FLT3-ITD negative-patients (N = 608) (P = 0.17, median OS was 5 vs 7.3 months respectively). NPM1-mutated patients (N = 144) also showed a non-significant difference with NPM1 wild type (N = 519) patients (P = 0.25, median OS 7.2 vs 6.8 respectively). In the Cox regression analysis neither NPM1 nor FLT3-ITD nor age were significant prognostic variables for OS prediction. Abnormal karyotype and a high leukocyte count showed a statistically significant deleterious effect. Azacitidine also showed better survival compared to FLUGA (low dose cytarabine plus fludarabine). NPM1 and FLT3-ITD seem to lack prognostic value in older/unfit AML patients treated with non-intensive regimens other than azacitidine-venetoclax combination.

2.
Leukemia ; 21(3): 446-52, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17205057

RESUMO

To determine prognosis of acute promyelocytic leukemia (APL) failing to front-line therapy with all-trans retinoic acid (ATRA) and anthracyclines, outcome of 52 patients (32 M/20 F; age: 37, 3-72) included in PETHEMA trials LPA96 and LPA99 who presented with either molecular failure (MOLrel, n=16) or hematological relapse (HEMrel, n=36) was analyzed. Salvage therapy consisted of ATRA and high-dose ara-C-based chemotherapy (HDAC) in most cases (83%), followed by stem-cell transplantation (autologous, 18; allogeneic, 10; syngeneic, 1). Fourteen patients with MOLrel (88%) achieved second molecular complete response (molCR), whereas 81% HEMrel patients responded to second-line treatment, with 58% molCR. After median follow-up of 45 months, four MOLrel and 18 HEMrel patients, respectively, experienced a second relapse. Outcome after MOLrel compared favorably to HEMrel, with longer survival (5-year survival: 64+/-14 vs 24+/-8%, P=0.01) and lower relapse risk (5-year relapse risk: 30+/-13 vs 64+/-9%; P=0.044). Additionally, age

Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Promielocítica Aguda/tratamento farmacológico , Terapia de Salvação , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Biomarcadores Tumorais/sangue , Criança , Pré-Escolar , Terapia Combinada , Citarabina/administração & dosagem , Etoposídeo/administração & dosagem , Feminino , Transplante de Células-Tronco Hematopoéticas , Humanos , Idarubicina/administração & dosagem , Estimativa de Kaplan-Meier , Leucemia Promielocítica Aguda/sangue , Leucemia Promielocítica Aguda/mortalidade , Leucemia Promielocítica Aguda/patologia , Leucemia Promielocítica Aguda/cirurgia , Lipossomos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Mitoxantrona/administração & dosagem , Neoplasia Residual , Proteínas de Fusão Oncogênica/sangue , Prognóstico , Recidiva , Indução de Remissão , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Tretinoína/administração & dosagem
4.
Ann Hematol ; 62(6): 232-4, 1991 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-1854887

RESUMO

We report a typical case of post-transfusion purpura (PTP) due to anti-PlA1 in a 65-year-old woman. Serological studies were carried out using flow cytometry (FCM). The patient also developed red cell alloantibodies that produced a delayed hemolytic transfusion reaction (DHTR) and broad HLA antibodies. Treatment with high-dose intravenous IgG (HDIgG; a first-generation preparation) was ineffective, but a course of steroids resulted in a rapid increase in the the platelet count.


Assuntos
Púrpura/etiologia , Reação Transfusional , Idoso , Anticorpos/análise , Plaquetas/imunologia , Relação Dose-Resposta a Droga , Feminino , Citometria de Fluxo , Granulócitos/imunologia , Humanos , Imunoglobulina G/administração & dosagem , Metilprednisolona/uso terapêutico , Púrpura/tratamento farmacológico
6.
Blut ; 59(6): 501-2, 1989 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2597775

RESUMO

Lymphocytosis of large granular lymphocytes (LGL) with severe neutropenia was diagnosed in a 42-years old patient. After prednisone yielded only a transitory effect, long lasting improvement was achieved by treatment with cyclosporin A.


Assuntos
Agranulocitose/complicações , Ciclosporinas/uso terapêutico , Granulócitos/patologia , Linfocitose/complicações , Neutropenia/complicações , Adulto , Antígenos CD/análise , Humanos , Linfócitos/imunologia , Linfócitos/fisiologia , Linfocitose/tratamento farmacológico , Linfocitose/patologia , Masculino , Fenótipo
7.
Cancer ; 61(1): 7-13, 1988 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-3422032

RESUMO

From December 1976 to July 1986, 34 patients with acute promyelocytic leukemia (APL) were treated with daunorubicin (DNR) alone and simultaneous supportive therapy with low-dose heparin, platelet transfusions, and fresh frozen plasma. Two consecutive maintenance therapy regimens were employed in patients who achieved complete remission (CR): (1) a classical maintenance with methotrexate and 6-mercaptopurine, with DNR plus methyl-GAG re-inductions; (2) from 1982 an intensive sequential combination therapy regimen was administered. CR was achieved in 23 patients (68%). Only one patient had leukemic resistance. Other failures were a consequence of post-chemotherapy complications. A multivariate logistic regression analysis has been performed to evaluate the prognostic importance on response to remission induction of 25 patient and disease characteristics at diagnosis. The significant variables in decreasing order of significance were: serum albumin level, fever at diagnosis, serum creatinine level, and age. The median duration of remission and survival by Kaplan-Meier analysis were projected to be 24 and 25 months, respectively. Relapses occurred in 11 of 23 CR patients. Nine patients remained in the first remission from 5+ to 37+ months. Short-term (CR) and long-term results (duration of remission and survival) in APL treated for induction with DNR alone were similar to those obtained in other subtypes of acute myeloblastic leukemia by intensive combination chemotherapy.


Assuntos
Leucemia Mieloide Aguda/tratamento farmacológico , Adolescente , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Daunorrubicina/efeitos adversos , Daunorrubicina/uso terapêutico , Feminino , Humanos , Leucemia Mieloide Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Prognóstico , Recidiva
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