Gemtuzumab Ozogamicin in Favorable and Intermediate Risk Acute Myeloid Leukemia: A Single-Center Experience
Notice bibliographique
Résumé
Background Acute Myeloid Leukemia (AML) is a common form of leukemia in adults. Gemtuzumab Ozogamicin (GO), an anti-CD33 antibody linked to a chemotherapy molecule, demonstrated improved event-free survival (EFS) and overall survival (OS) in favorable and intermediate risk AML when given with standard induction chemotherapy. Purpose This retrospective study will examine outcomes of AML patients at the McGill University Health Center (MUHC) who received GO with standard induction chemotherapy compared to induction chemotherapy alone. Methods We selected favorable and intermediate risk AML patients who received GO with induction chemotherapy from January 1, 2015, to November 23, 2023, with matched controls based on cytogenetic and molecular characteristics. The European LeukemiaNet AML classification was used, noting that the ALFA-0701 study identified favorable patients based on cytogenetics and NPM1 or CEBPA mutations. We extracted age, sex, length of hospital stays, complete remission (CR), time to neutrophil (ANC >1.0) and platelet (platelet >50 and >100) recovery, hepatic toxicity (bilirubin >1.5x upper limit of normal (ULN), transaminases >3x ULN, or veno-occlusive disease (VOD)), stem cell transplantation (SCT), relapse rate, and survival. We performed statistical analysis to obtain hazard ratios (HR) and odds ratios (OR). Results Our cohort had 16 GO and 16 control patients, evenly distributed across favorable and intermediate AML risk categories. GO patients received treatment between 2020 and 2023, and controls between 2016 and 2022. Median age was 56.0 years (range 19-71) in GO and 53.5 years (range 23-71) in controls. Both groups had 63% male patients. Mean duration of follow-up was 12.8 months in GO and 39.8 months in controls. There was no increase in hepatic toxicity in GO compared to controls (19% versus 25%; OR 0.69, 95% CI 0.13-3.75), no longer mean platelet recovery time (plt >50 in 26.8 days vs. 27.0 days; HR 0.58, 95% CI 0.28-1.20) nor longer mean neutrophil recovery time (ANC >1.0 in 32.4 days vs. 30.5 days; HR 0.79, 95% CI 0.39-1.59). Other parameters did not demonstrate statistical significance in GO compared to controls, including mean length of stay (37.9 days vs. 37.8 days; HR 0.879, 95% CI 0.43-1.78), CR (88% vs. 94%; HR 1.65, 95% CI 0.32-8.58), one-year relapse (12.5% vs. 6.3%; OR 2.14 95% CI 0.17-26.33), and one-year survival (93.8% vs. 87.0%; OR 2.31 95% CI 0.19-28.47). GO patients showed a trend to being less likely to receive SCT. Conclusion GO was well-tolerated with no increase in delayed cell count recovery or hepatic toxicity, in contrast to the ALFA-0701 study. There were no significant differences in CR or relapse rates. A trend towards decreased SCT was observed with GO, which was likely due to the selection of more non-transplant candidates in the intermediate risk group to receive GO, based on the consideration that they would benefit the most. The absence of significant differences may be due to the small cohort size and short follow-up time. Further evaluation of this cohort will help clarify these outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».