%0 Journal Article
%A Bergua, Juan M
%A Montesinos, Pau
%A Martinez-Cuadron, David
%A Fernandez-Abellan, Pascual
%A Serrano, Josefina
%A Sayas, Maria J
%A Prieto-Fernandez, Julio
%A Garcia, Raimundo
%A Garcia-Huerta, Ana J
%A Barrios, Manuel
%A Benavente, Celina
%A Perez-Encinas, Manuel
%A Simiele, Adriana
%A Rodriguez-Macias, Gabriela
%A Herrera-Puente, Pilar
%A Rodriguez-Veiga, Rebeca
%A Martinez-Sanchez, Maria P
%A Amador-Barciela, Maria L
%A Riaza-Grau, Rosalia
%A Sanz, Miguel A
%T A prognostic model for survival after salvage treatment with FLAG-Ida +/- gemtuzumab-ozogamicine in adult patients with refractory/relapsed acute myeloid leukaemia.
%D 2016
%U http://hdl.handle.net/10668/10029
%X The combination of fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor (FLAG-Ida) is widely used in relapsed/refractory acute myeloid leukaemia (AML). We retrospectively analysed the results of 259 adult AML patients treated as first salvage with FLAG-Ida or FLAG-Ida plus Gentuzumab-Ozogamicin (FLAGO-Ida) of the Programa Español de Tratamientos en Hematología (PETHEMA) database, developing a prognostic score system of survival in this setting (SALFLAGE score). Overall, 221 patients received FLAG-Ida and 38 FLAGO-Ida; 92 were older than 60 years. The complete remission (CR)/CR with incomplete blood count recovery (CRi) rate was 51%, with 9% of induction deaths. Three covariates were associated with lower CR/CRi: high-risk cytogenetics and t(8;21) at diagnosis, no previous allogeneic stem cell transplantation (allo-SCT) and relapse-free interval <1 year. Allo-SCT was performed in second CR in60 patients (23%). The median overall survival (OS) of the entire cohortwas 07 years, with 22% OS at 5-years. Four independent variables wereused to construct the score: cytogenetics, FLT3-internal tandem duplica-tion, length of relapse-free interval and previous allo-SCT. Using this strati-fication system, three groups were defined: favourable (26% of patients),intermediate (29%) and poor-risk (45%), with an expected 5-year OS of52%, 26% and 7%, respectively. The SALFLAGE score discriminated a sub-set of patients with an acceptable long-term outcome using FLAG-Ida/FLAGO-Ida regimen. The results of this retrospective analysis should bevalidated in independent external cohorts
%K FLAG-Ida
%K Genetic risk
%K Prognostic factors
%K Relapsed-refractory acute myeloid leukaemia
%K Salvage treatment
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