TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS

Patients with ≥ 20% <30% bone marrow blast infiltration previously regarded as a transitional category between myelodisplasia and acute myeloid leukemia (AML) according to FAB classification, have been subsequently included into AML WHO classification. However, controversies still remain as to wh...

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Main Authors: Luca Maurillo, Francesco Buccisano, Maria Ilaria Del Principe, Chiara Sarlo, Luigi Di Caprio, Concetta Ditto, Federica Giannotti, Daniela Nasso, Eleonora Ceresoli, Massimiliano Postorino, Marco Refrigeri, Sergio Amadori, Adriano Venditti
Format: Article
Language:English
Published: PAGEPress Publications 2013-06-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/index.php/mjhid/article/view/412
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author Luca Maurillo
Francesco Buccisano
Maria Ilaria Del Principe
Chiara Sarlo
Luigi Di Caprio
Concetta Ditto
Federica Giannotti
Daniela Nasso
Eleonora Ceresoli
Massimiliano Postorino
Marco Refrigeri
Sergio Amadori
Adriano Venditti
author_facet Luca Maurillo
Francesco Buccisano
Maria Ilaria Del Principe
Chiara Sarlo
Luigi Di Caprio
Concetta Ditto
Federica Giannotti
Daniela Nasso
Eleonora Ceresoli
Massimiliano Postorino
Marco Refrigeri
Sergio Amadori
Adriano Venditti
author_sort Luca Maurillo
collection DOAJ
description Patients with ≥ 20% <30% bone marrow blast infiltration previously regarded as a transitional category between myelodisplasia and acute myeloid leukemia (AML) according to FAB classification, have been subsequently included into AML WHO classification. However, controversies still remain as to whether the natural history and responsiveness to therapy of these patients is comparable to that of patients with > 30% BM blast AML. In the present review, we will discuss the clinical results achieved in the treatment of elderly patients with 20%-30% BM blasts AML using intensive chemotherapy (IC) or hypomethylating agents. Overall, due to concerns of treatment-related morbidity and mortality associated with delivery of IC, approximately only 30% of all patients ≥ 65 years are considered eligible for this approach. Therefore, a great deal of attention has been dedicated to hypomethilating agents such as azacitidine and decitabine. These agents have shown efficacy, with reduced toxicity as compared with IC, when administered to elderly patients not eligible for IC and with 20-30% BM blasts and multilineage dysplasia. Future randomized clinical trials are eagerly awaited to determine whether hypomethylating agents can substitute for IC even in elderly patients with good functional status.
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spelling doaj-art-d2ee3eb7c165461a9bd888cc42957ba82025-08-20T02:08:35ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062013-06-0151e2013032e201303210.4084/mjhid.2013.032304TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTSLuca Maurillo0Francesco Buccisano1Maria Ilaria Del Principe2Chiara Sarlo3Luigi Di Caprio4Concetta Ditto5Federica Giannotti6Daniela Nasso7Eleonora Ceresoli8Massimiliano Postorino9Marco Refrigeri10Sergio Amadori11Adriano Venditti12Cattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomeCattedra di Ematologia, Università di Tor Vergata, RomePatients with ≥ 20% <30% bone marrow blast infiltration previously regarded as a transitional category between myelodisplasia and acute myeloid leukemia (AML) according to FAB classification, have been subsequently included into AML WHO classification. However, controversies still remain as to whether the natural history and responsiveness to therapy of these patients is comparable to that of patients with > 30% BM blast AML. In the present review, we will discuss the clinical results achieved in the treatment of elderly patients with 20%-30% BM blasts AML using intensive chemotherapy (IC) or hypomethylating agents. Overall, due to concerns of treatment-related morbidity and mortality associated with delivery of IC, approximately only 30% of all patients ≥ 65 years are considered eligible for this approach. Therefore, a great deal of attention has been dedicated to hypomethilating agents such as azacitidine and decitabine. These agents have shown efficacy, with reduced toxicity as compared with IC, when administered to elderly patients not eligible for IC and with 20-30% BM blasts and multilineage dysplasia. Future randomized clinical trials are eagerly awaited to determine whether hypomethylating agents can substitute for IC even in elderly patients with good functional status.http://www.mjhid.org/index.php/mjhid/article/view/412Acute myeloid leukemia, Refractory anaemia with excess of blasts in transformation, World Health Organization classification
spellingShingle Luca Maurillo
Francesco Buccisano
Maria Ilaria Del Principe
Chiara Sarlo
Luigi Di Caprio
Concetta Ditto
Federica Giannotti
Daniela Nasso
Eleonora Ceresoli
Massimiliano Postorino
Marco Refrigeri
Sergio Amadori
Adriano Venditti
TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
Mediterranean Journal of Hematology and Infectious Diseases
Acute myeloid leukemia, Refractory anaemia with excess of blasts in transformation, World Health Organization classification
title TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
title_full TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
title_fullStr TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
title_full_unstemmed TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
title_short TREATMENT OF ACUTE MYELOID LEUKEMIA WITH 20-30% BONE MARROW BLASTS
title_sort treatment of acute myeloid leukemia with 20 30 bone marrow blasts
topic Acute myeloid leukemia, Refractory anaemia with excess of blasts in transformation, World Health Organization classification
url http://www.mjhid.org/index.php/mjhid/article/view/412
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