Titre :

Clofarabine Improves Relapse-Free Survival of Acute Myeloid Leukemia in Younger Adults with Micro-Complex Karyotype

Auteur(s) :

Fenwarth, Laurène [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Institut de Pathologie [CHU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Duployez, Nicolas [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Service de pathologie [CHU Lille]
Thomas, Xavier [Auteur]
Centre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
Boissel, Nicolas [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Recherche clinique appliquée à l'hématologie [URP_3518]
Geffroy, Sandrine [Auteur]
Institut pour la recherche sur le cancer de Lille [Lille] [IRCL]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Marceau-Renaut, Alice [Auteur]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Caillot, Denis [Auteur]
Service d'Hématologie Clinique (CHU de Dijon)
Raffoux, Emmanuel [Auteur]
Service d'hématologie biologique
Lemasle, Emilie [Auteur]
Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel]
Marolleau, Jean-Pierre [Auteur]
CHU Amiens-Picardie
HEMATIM - Hématopoïèse et immunologie - UR UPJV 4666 [HEMATIM]
Berthon, Céline [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Cheok, Meyling [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Peyrouze, Pauline [Auteur]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Pigneux, Arnaud [Auteur]
Biothérapies des maladies génétiques et cancers
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Vey, Norbert [Auteur]
Centre de Recherche en Cancérologie de Marseille [CRCM]
Institut Paoli-Calmettes [IPC]
Celli-Lebras, Karine [Auteur]
Terré, Christine [Auteur]
Centre Hospitalier de Versailles André Mignot [CHV]
Preudhomme, Claude [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 [JPArc]
Dombret, Hervé [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Recherche clinique appliquée à l'hématologie [URP_3518]

Titre de la revue :

Cancers

Pagination :

88

Éditeur :

MDPI

Date de publication :

2020

ISSN :

2072-6694

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Acute myeloid leukemia (AML) encompasses heterogeneous entities with dismal outcomes. Intermediate and unfavorable-risk AML represent the most difficult-to-treat entities. We recently reported the benefit of the clofarabine-based ...
Lire la suite >Acute myeloid leukemia (AML) encompasses heterogeneous entities with dismal outcomes. Intermediate and unfavorable-risk AML represent the most difficult-to-treat entities. We recently reported the benefit of the clofarabine-based consolidation (CLARA) regimen compared to the standard high-dose cytarabine (HDAC) regimen in younger AML patients. Here, we aimed at assessing the clinical significance of single-nucleotide polymorphism (SNP)-array alterations and their interactions with chemotherapy regimens. A SNP-array was successfully performed in 187 out of the 221 intent-to-treat patients (CLARA arm: n = 92 patients, HDAC arm: n = 95 patients). The CLARA regimen did not significantly improve relapse-free survival (RFS) among patients who displayed a complex karyotype when compared to the HDAC regimen (4-year RFS (4y-RFS): 36.4% vs. 18.8%, respectively; p = 0.134). Defining micro-complex karyotypes from at least four SNP-array lesions enabled us to refine and enlarge the subset of adverse patients. In such patients, the CLARA regimen significantly improved RFS compared to the HDAC regimen (4y-RFS: 44.4% vs. 13.8%, respectively; p = 0.004). From our study cohort, 8% of patients displayed TP53 mutations, which were associated with an impaired RFS (4y-RFS: 20.0% vs 43.7%; p = 0.029). In a multivariate analysis, micro-complex karyotypes remained the sole poor prognostic factor in the HDAC arm (hazard ratio (HR) = 2.324 (95% confidence interval (CI) = 1.337-4.041), p = 0.003). The SNP array represents a powerful and reproductive approach to refine adverse AML patients that may benefit from alternative consolidation regimens.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER) - UMR 9020 - UMR 1277

Source :

Harvested from HAL