Association of fludarabin, cytarabine, and fractioned gemtuzumab followed by hematopoietic stem cell transplantation for first-line refractory acute myeloid leukemia in children: A single-center experience.
Adolescent
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Child
Combined Modality Therapy
Cytarabine
/ administration & dosage
Drug Resistance, Neoplasm
Female
Follow-Up Studies
Gemtuzumab
/ administration & dosage
Hematopoietic Stem Cell Transplantation
/ mortality
Humans
Leukemia, Myeloid, Acute
/ pathology
Male
Neoplasm Recurrence, Local
/ pathology
Prognosis
Retrospective Studies
Salvage Therapy
Survival Rate
Vidarabine
/ administration & dosage
AML: molecular diagnosis and therapy
gemtuzumab
minimal residual disease
pediatric hematology/oncology
refractory AML
salvage therapy
Journal
Pediatric blood & cancer
ISSN: 1545-5017
Titre abrégé: Pediatr Blood Cancer
Pays: United States
ID NLM: 101186624
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
04
12
2019
revised:
17
03
2020
accepted:
18
03
2020
pubmed:
21
4
2020
medline:
18
8
2020
entrez:
21
4
2020
Statut:
ppublish
Résumé
Acute myeloid leukemia (AML) is a rare disease in children, with only 50% to 60% event-free survival. Among patients with AML, 10% do not respond to first-line chemotherapy. There is no recommendation concerning second-line treatments. Gemtuzumab ozogamicin (GO) is a monoclonal antibody targeting CD33, linked to calicheamicin. We report the efficacy and tolerance of a salvage regimen of fludarabin, cytarabine, and GO (FLA-GO) in patients refractory to first-line treatment. Eight patients (median age 14.5 years), who had more than 2% minimal residual disease (MRD) by flow cytometry (MRD flow), received gemtuzumab 3 mg/m² on days 1, 4, 7, associated with cytarabine 2000 mg/m² and fludarabin 30 mg/m² on days 1 to 5. Six patients achieved complete remission (CR) (blast count morphology ≤5 × 10 FLA-GO is a good salvage regimen for pediatric refractory AML, with significant but acceptable toxicity. HSCT is mandatory to achieve sustained CR in these patients.
Substances chimiques
Cytarabine
04079A1RDZ
Gemtuzumab
93NS566KF7
Vidarabine
FA2DM6879K
fludarabine
P2K93U8740
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e28305Informations de copyright
© 2020 Wiley Periodicals, Inc.
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