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Master Thesis

Association du gemtuzumab ozogamycine et de la cytarabine dans le traitement des premières rechutes de leucémies aiguës myéloïdes

Abstract : Introduction: although the majority of adult acute myeloid leukemia (AML) patients achieve complete remission (CR), a relapse still occurs in 35-80% and long-term survival rates remain extremely low after relapse (10-20%). At relapse, the common admitted strategy is to reach a second CR (CR2) and to bridge eligible patients to allogeneic hematopoietic stem cell transplantation (HSCT). We assessed the efficacy and safety of gemtuzumab ozogamycin (GO, anti-CD33 linked to calicheamicin) combined with cytarabine (GO+AraC) in relapsed AML. Methods: a retrospective study was conducted among relapsed AML patients in Saint-Louis Hospital (Paris, France) from January 2008 to December 2018, all consecutive patients with AML in first relapse treated with GO+AraC were included. Results: 71 patients with a median age of 45,6 (17-77,2) were included. ELN-2010 classification was favorable in 42 patients (59%), intermediate in 19 (27%), and unfavorable in 10 (14%). Median follow-up was 1.5 years. Overall response rate after salvage was 77% (N=55) with 52 patients (74%) achieving CR. Thirty patients (54%) were bridged to HSCT in CR2. During salvage 6 sinusoidal obstruction syndromes. were found. Non-relapse mortality at 3 years was 12% (95% CI, [6- 23]). The 3-year cumulative incidence of relapse was 55% (95% CI [40-71]). The 3-year overall survival (OS) was 43% (95% CI, 30-56). Factors associated with decreased OS were a shorter time to relapse and unfavorable ELN status. Conclusion: in patients with AML in first relapse, GO+Arac is an efficient salvage regimen, especially in patients with ELN favorable/intermediate profile and time to relapse of more than 12 months.
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Master Thesis
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Submitted on : Tuesday, February 16, 2021 - 9:25:47 AM
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  • HAL Id : dumas-03142470, version 1


Aude-Marie Fourmont. Association du gemtuzumab ozogamycine et de la cytarabine dans le traitement des premières rechutes de leucémies aiguës myéloïdes. Médecine humaine et pathologie. 2019. ⟨dumas-03142470⟩



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