Introduction Clinical response and chemosensitivity of relapse or refractory AML patients were evaluated after rescue and bridge-to-transplant MEC (mitoxantrone, etoposide, and cytarabine) regimen.Methods and Patients Fifty-five consecutive AML patients were treated with MEC from 2009 to 2018. Chemosensitivity was evaluated by WT1 quantification.Results 27/55 patients (49.1%) had AML resistant to induction and 28/55 patients (50.9%) had AML relapse. 25/55 patients (45.5%) achieved a CR after one course of MEC, and 12 patients (21.8%) achieved WT1 negativity. In 12 patients, a second MEC was administered. Four out of 12 patients improved significantly their response with the 2nd MEC. MEC was an effective bridge to transplant, 32/55 patients (58.2%) received an allogenic stem cell transplant. Median overall survival (OS) from MEC was 455 days (95% CI 307-602 days.); patient with WT1 negative CR had the best OS (P<.000).Conclusion WT1 is a useful marker of chemosensitivity after MEC as rescue and bridge-to-transplant therapy.
MEC (mitoxantrone, etoposide, and cytarabine) induces complete remission and is an effective bridge to transplant in acute myeloid leukemia / Marconi, Giovanni; Talami, Annalisa; Abbenante, Maria Chiara; Sartor, Chiara; Parisi, Sarah; Nanni, Jacopo; Bertamini, Luca; Ragaini, Simone; Olivi, Matteo; de Polo, Stefano; Cristiano, Gianluca; Fontana, Maria Chiara; Bochicchio, Maria Teresa; Ottaviani, Emanuela; Arpinati, Mario; Sessa, Mariarosaria; Baldazzi, Carmen; Caso, Lucia; Testoni, Nicoletta; Baccarani, Michele; Bonifazi, Francesca; Martinelli, Giovanni; Paolini, Stefania; Cavo, Michele; Papayannidis, Cristina; Curti, Antonio. - In: EUROPEAN JOURNAL OF HAEMATOLOGY. - ISSN 1600-0609. - 105:1(2020), pp. 47-55. [10.1111/ejh.13406]
MEC (mitoxantrone, etoposide, and cytarabine) induces complete remission and is an effective bridge to transplant in acute myeloid leukemia
Talami, Annalisa;Curti, Antonio
2020
Abstract
Introduction Clinical response and chemosensitivity of relapse or refractory AML patients were evaluated after rescue and bridge-to-transplant MEC (mitoxantrone, etoposide, and cytarabine) regimen.Methods and Patients Fifty-five consecutive AML patients were treated with MEC from 2009 to 2018. Chemosensitivity was evaluated by WT1 quantification.Results 27/55 patients (49.1%) had AML resistant to induction and 28/55 patients (50.9%) had AML relapse. 25/55 patients (45.5%) achieved a CR after one course of MEC, and 12 patients (21.8%) achieved WT1 negativity. In 12 patients, a second MEC was administered. Four out of 12 patients improved significantly their response with the 2nd MEC. MEC was an effective bridge to transplant, 32/55 patients (58.2%) received an allogenic stem cell transplant. Median overall survival (OS) from MEC was 455 days (95% CI 307-602 days.); patient with WT1 negative CR had the best OS (P<.000).Conclusion WT1 is a useful marker of chemosensitivity after MEC as rescue and bridge-to-transplant therapy.
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