Acute Myeloid Leukemia Clinical Trial
Official title:
Transfusion Dependency at Diagnosis and Transfusion Intensity During Initial Chemotherapy Are Associated With Poorer Outcomes in Adult Acute Myeloid Leukemia
Acute myeloid leukaemia (AML) is a haematological malignant disease characterized by an
uncontrolled proliferation of immature hematopoietic cells. Over the last two decades,
clinical trials have demonstrated an improved response rate in younger adult AML. Aggressive
induction plus more potent intensification programs with chemotherapy alone or chemotherapy
plus stem cell transplantation (SCT) has improved treatment results. Advances in
understanding disease biology, improvements in induction and consolidation program, and
better supportive care have also all contributed. A number of clinical and laboratory
characteristics influence the response to treatment and, thus, the survival of patients with
AML. Among them, cytogenetic at diagnosis represents the most important prognostic variable.
However, other factors may have a prognostic value and may influence patient's outcome.
Anaemia and thrombocytopenia are cardinal manifestations of AML. Over the last decades, it
has become apparent that the frequency of allogeneic blood transfusions can modify host
immunity and clinical outcomes. Anaemia has long been recognized as an adverse prognostic
factor in myelodysplastic syndrome (MDS), which represents a pre-leukemic disease. Red blood
cell (RBC) transfusion need was identified as a strong and independent risk factor for
survival in MDS, for which the presence and severity of anaemia were attributed to a
clonally advanced and biologically more aggressive disease.
Based on these data, we retrospectively assessed the prognostic value of RBC and platelet
transfusions at the time of diagnosis and the frequency of transfusions during the first
induction course of chemotherapy in a large unselected group of patients with previously
untreated AML.
Status | Completed |
Enrollment | 1067 |
Est. completion date | July 2015 |
Est. primary completion date | December 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 15 Years and older |
Eligibility |
Inclusion Criteria: - Patient > 15 years old - Newly diagnosed AML or post myelodysplastic syndrome (MDS) Exclusion Criteria: - Patients with M3 AML of FAB classification (APL, Acute Promyelocytic Leukemia) - World Health Organization (WHO) performance status >2; - Left ventricular systolic ejection fraction below the normal range - Patients who have any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study - Serum creatinine concentration > 2x ULN (Upper Limit of Normal laboratory ranges), - AST or ALT levels > 2.0 x ULN, except if AML-related |
Observational Model: Cohort, Time Perspective: Retrospective
Country | Name | City | State |
---|---|---|---|
n/a |
Lead Sponsor | Collaborator |
---|---|
Hospices Civils de Lyon |
Cannas G, Fattoum J, Raba M, Dolange H, Barday G, François M, Elhamri M, Salles G, Thomas X. Transfusion dependency at diagnosis and transfusion intensity during initial chemotherapy are associated with poorer outcomes in adult acute myeloid leukemia. Ann — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Overall survival (OS) | Overall survival (OS) is defined as the time elapsed between induction chemotherapy regimen and death for any cause. Patients not known to have this event are censored on the date they were last examined | 3 year OS | No |
Primary | Overall survival (OS) | Overall survival (OS) is defined as the time elapsed between induction chemotherapy regimen and death for any cause. Patients not known to have this event are censored on the date they were last examined | 7 year OS | No |
Secondary | Complete remission (CR) rate | Response to induction therapy was assessed after one or two courses of chemotherapy. CR was defined according to standard criteria as less than 5 % blasts in bone marrow aspirates with evidence of maturation of cell lines and restoration of peripheral blood counts | Up to 10 weeks | No |
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