Treatment of core-binding-factor in acute myelogenous leukemia with fludarabine, cytarabine, and granulocyte colony-stimulating factor results in improved event-free survival.
Treatment of core-binding-factor in acute myelogenous leukemia with fludarabine, cytarabine, and granulocyte colony-stimulating factor results in improved event-free survival.
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DOI：
10.1002/cncr.23927
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发表时间：
2008-12-01
期刊：
影响因子：
6.2
通讯作者：
Estey EH
中科院分区：
文献类型：
--
作者：
Borthakur G;Kantarjian H;Wang X;Plunkett WK Jr;Gandhi VV;Faderl S;Garcia-Manero G;Ravandi F;Pierce S;Estey EH
急性髓性白血病（AML）合并核心结合因子异常（CBF）是对阿糖胞苷（ara-C）治疗最敏感的白血病类型，预后相对较好。体外和离体观察表明，受氟达拉滨和粒细胞集落刺激因子（GCSF）的影响，细胞内ara-C水平的增加增加了ara-C的作用；提示我们临床评估这些组合的疗效。我们分析了氟达拉滨和ara-C (FA) （N=45）或FA和GCSF (FLAG)（N=22）治疗的新诊断CBF AML患者的无事件生存率，并将结果与伊达柔比星和ara-C联合或不联合GCSF （IA/IAG）治疗的患者（N=47）进行了比较。我们证明，在考虑治疗以外的预后协变量（包括治疗实施的年份）后；FA，特别是FLAG，与IA/IAG相比，具有更长的无事件生存期（EFS）。因此，我们的数据为氟达拉滨和G-CSF对ara-C的调节提供了临床依据。
Acute myelogenous leukemia (AML) associated with core binding factor abnormalities (CBF) is the type of leukemia most responsive to cytarabine (ara-C) therapy and is of relative favorable prognosis. In vitro and ex vivo observations suggest that increases in intra-cellular ara-C levels influenced by administration of fludarabine and granulocyte colony stimulating factor (GCSF) increase the effect of ara-C; prompting us to clinically evaluate the efficacy of such combinations. We analyzed the event free survival of patients with newly diagnosed CBF AML treated with fludarabine and ara-C (FA) (N=45) or with FA and GCSF (FLAG)(N=22) and compared results to patients treated with regimens consisting of idarubicin and ara-C with or without GCSF (IA/IAG)(N=47). We demonstrate that after accounting for prognostic covariates other than treatment (including year in which treatment was administered); FA, and in particular FLAG, were associated with longer event free survival (EFS) than IA/IAG. Thus our data lends clinical credence to the observed modulation of ara-C by fludarabine and G-CSF.
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影响因子：
11.4
作者：
Marcucci, G;Livak, KJ;Caligiuri, MA
通讯作者：
Caligiuri, MA
影响因子：
3.7
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KAPLAN, EL;MEIER, P
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MEIER, P
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Appelbaum, Frederick R.;Kopecky, Kenneth J.;Estey, Elihu H.
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