CNS involvement in AML at diagnosis is rare and does not affect response or survival : data from 11 ECOG-ACRIN trials
© 2021 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved..
Central nervous system (CNS) involvement in patients with newly diagnosed acute myeloid leukemia (AML) is rare, and systematic data regarding outcome are scarce. This retrospective study summarized data from 11 consecutive Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) clinical trials for patients with newly diagnosed AML. In all, 3240 patients with AML were analyzed, and 36 (1.11%) were found to have CNS involvement at diagnosis. The incidence of CNS disease among the 5 studies with per protocol mandatory lumbar puncture (LP) was similar to the incidence among studies in which LP was performed at the discretion of the investigator (0.86% vs 1.41%; P = .18). There was no significant difference in the rate of complete remission (CR) among patients with CNS involvement and those with other extramedullary disease (EMD) sites or those with no EMD (52.8% vs 59.3%-60%). The median overall survival (OS) for patients who were CNS positive, who had other EMD, or who had no EMD was 11.4, 11.3, and 12.7 months, respectively. There was no difference in OS among patients with CNS involvement, those with other EMD (hazard ratio [HR], 0.96; adjusted P = .84), and those with no EMD (HR, 1.19; adjusted P = .44). In conclusion, the reported incidence of CNS involvement in patients with newly diagnosed AML is low (1.1%), irrespective of whether an LP is mandatory or not. The presence of CNS disease at diagnosis in and of itself does not seem to portend a poor prognosis for achieving an initial CR or for OS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Blood advances - 5(2021), 22 vom: 23. Nov., Seite 4560-4568 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ganzel, Chezi [VerfasserIn] |
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| Anmerkungen: |
Date Completed 29.11.2021 Date Revised 08.04.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1182/bloodadvances.2021004999 |
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| Förderinstitution / Projekttitel: |
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NLM331387786 |
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| 520 | |a Central nervous system (CNS) involvement in patients with newly diagnosed acute myeloid leukemia (AML) is rare, and systematic data regarding outcome are scarce. This retrospective study summarized data from 11 consecutive Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) clinical trials for patients with newly diagnosed AML. In all, 3240 patients with AML were analyzed, and 36 (1.11%) were found to have CNS involvement at diagnosis. The incidence of CNS disease among the 5 studies with per protocol mandatory lumbar puncture (LP) was similar to the incidence among studies in which LP was performed at the discretion of the investigator (0.86% vs 1.41%; P = .18). There was no significant difference in the rate of complete remission (CR) among patients with CNS involvement and those with other extramedullary disease (EMD) sites or those with no EMD (52.8% vs 59.3%-60%). The median overall survival (OS) for patients who were CNS positive, who had other EMD, or who had no EMD was 11.4, 11.3, and 12.7 months, respectively. There was no difference in OS among patients with CNS involvement, those with other EMD (hazard ratio [HR], 0.96; adjusted P = .84), and those with no EMD (HR, 1.19; adjusted P = .44). In conclusion, the reported incidence of CNS involvement in patients with newly diagnosed AML is low (1.1%), irrespective of whether an LP is mandatory or not. The presence of CNS disease at diagnosis in and of itself does not seem to portend a poor prognosis for achieving an initial CR or for OS | ||
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| 700 | 1 | |a Fernandez, Hugo F |e verfasserin |4 aut | |
| 700 | 1 | |a Paietta, Elisabeth M |e verfasserin |4 aut | |
| 700 | 1 | |a Luger, Selina M |e verfasserin |4 aut | |
| 700 | 1 | |a Lazarus, Hillard M |e verfasserin |4 aut | |
| 700 | 1 | |a Cripe, Larry D |e verfasserin |4 aut | |
| 700 | 1 | |a Douer, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Wiernik, Peter H |e verfasserin |4 aut | |
| 700 | 1 | |a Rowe, Jacob M |e verfasserin |4 aut | |
| 700 | 1 | |a Tallman, Martin S |e verfasserin |4 aut | |
| 700 | 1 | |a Litzow, Mark R |e verfasserin |4 aut | |
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