| Title |
Combination of fludarabine, amsacrine, and cytarabine followed by reduced-intensity conditioning and allogeneic hematopoietic stem cell transplantation in patients with high-risk acute myeloid leukemia
|
|---|---|
| Published in |
Annals of Hematology, June 2013
|
| DOI | 10.1007/s00277-013-1790-5 |
| Pubmed ID | |
| Authors |
Marta Krejci, Michael Doubek, Jaroslav Dusek, Yvona Brychtova, Zdenek Racil, Milan Navratil, Miroslav Tomiska, Ondrej Horky, Sarka Pospisilova, Jiri Mayer |
| Abstract |
Sequential use of chemotherapy and reduced-intensity conditioning (RIC) with allogeneic stem cell transplantation (SCT) has been proposed to improve the treatment outcomes in patients with high-risk acute myeloid leukemia (AML). Here, we present our experience with this procedure in a cohort of 60 AML patients with primary induction failure (n = 9); early, refractory, or ≥ second relapse (n = 41); or unfavorable cytogenetics (n = 10). A combination of fludarabine (30 mg/m²/day), cytarabine (2 g/m²/day), and amsacrine (100 mg/m²/day) for 4 days was used. After 3 days of rest, RIC was carried out, consisting of 4 Gy total body irradiation, antithymocyte globulin (ATG-Fresenius), and cyclophosphamide (fludarabine, amsacrine, and cytarabine (FLAMSA)-RIC protocol). Prophylactic donor lymphocyte infusions (pDLIs) were given in patients with complete remission (CR) and without evidence of graft-versus-host disease ≥120 days after SCT. The median time of neutrophil engraftment was 17 days. CR was achieved in 47 of 60 patients (78%). Eleven patients received pDLIs resulting in long-term CR in eight of them. Non-relapse mortality after 1 and 3 years was 25 and 28%, respectively. With a median follow-up of 37 months (range, 10-69), 3-year overall survival and 3-year progression-free survival were 42 and 33%, respectively. In a multivariate analysis, dose of CD34(+) cells >5 × 10⁶/kg (p = 0.005; hazard ratio (HR) = 0.276), remission of AML before SCT (p = 0.044; HR = 0.421), and achievement of complete chimerism after SCT (p = 0.001; HR = 0.205) were significant factors of better overall survival. The use of the FLAMSA-RIC protocol in suitable high-risk AML patients results in a long-term survival rate of over 40%. |
Mendeley readers
The data shown below were compiled from readership statistics for 25 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Czechia | 1 | 4% |
| Australia | 1 | 4% |
| Unknown | 23 | 92% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 40% |
| Other | 4 | 16% |
| Professor | 2 | 8% |
| Student > Doctoral Student | 1 | 4% |
| Student > Ph. D. Student | 1 | 4% |
| Other | 3 | 12% |
| Unknown | 4 | 16% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 64% |
| Business, Management and Accounting | 1 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
| Immunology and Microbiology | 1 | 4% |
| Engineering | 1 | 4% |
| Other | 0 | 0% |
| Unknown | 5 | 20% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 September 2014.
All research outputs
#7,670,187
of 23,343,453 outputs
Outputs from Annals of Hematology
#457
of 2,224 outputs
Outputs of similar age
#66,224
of 195,524 outputs
Outputs of similar age from Annals of Hematology
#7
of 27 outputs
Altmetric has tracked 23,343,453 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,224 research outputs from this source. They receive a mean Attention Score of 4.2. This one has gotten more attention than average, scoring higher than 61% of its peers.
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We're also able to compare this research output to 27 others from the same source and published within six weeks on either side of this one. This one is in the 48th percentile – i.e., 48% of its contemporaries scored the same or lower than it.