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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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2013-06-01
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| 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. |
| format | Article |
| id | doaj-art-d2ee3eb7c165461a9bd888cc42957ba8 |
| institution | OA Journals |
| issn | 2035-3006 |
| language | English |
| publishDate | 2013-06-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| 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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