RT Journal Article T1 Differences in ex-vivo Chemosensitivity to Anthracyclines in First Line Acute Myeloid Leukemia. A1 Megias-Vericat, Juan Eduardo A1 Martinez-Cuadron, David A1 Martinez-Lopez, Joaquin A1 Bergua, Juan Miguel A1 Tormo, Mar A1 Serrano, Josefina A1 Gonzalez, Ataulfo A1 Perez-de-Oteyza, Jaime A1 Vives, Susana A1 Vidriales, Belen A1 Herrera, Pilar A1 Vera, Juan Antonio A1 Lopez-Martinez, Aurelio A1 de-la-Fuente, Adolfo A1 Amador, Ma Lourdes A1 Hernandez-Rivas, Jose-Angel A1 Fernandez, Ma Angeles A1 Cervero, Carlos Javier A1 Morillo, Daniel A1 Hernandez-Campo, Pilar A1 Gorrochategui, Julian A1 Primo, Daniel A1 Rojas, Jose Luis A1 Guenova, Margarita A1 Ballesteros, Joan A1 Sanz, Miguel A1 Montesinos, Pau K1 Acute myeloid leukemia K1 Anthracycline K1 Daunorubicin K1 Idarubicin K1 Mitoxantrone K1 Personalized medicine K1 ex-vivo test AB Induction schedules in acute myeloid leukemia (AML) are based on combinations of cytarabine and anthracyclines. The choice of the anthracycline employed has been widely studied in multiple clinical trials showing similar complete remission rates. Using an ex vivo test we have analyzed if a subset of AML patients may respond differently to cytarabine combined with idarubicin, daunorubicin or mitoxantrone. Bone marrow (BM) samples of 198 AML patients were incubated for 48 hours in 96 well plates, each well containing different drugs or drug combinations at different concentrations. Ex vivo drug sensitivity analysis was made using the PharmaFlow platform maintaining the BM microenvironment. Drug response was evaluated as depletion of AML blast cells in each well after incubation. Annexin V-FITC was used to quantify the ability of the drugs to induce apoptosis, and pharmacological responses were calculated using pharmacokinetic population models. Similar dose-respond graphs were generated for the three anthracyclines, with a slight decrease in EC50 with idarubicin (p=1.462E-06), whereas the interpatient variability of either drug was large. To identify those cases of selective sensitivity to anthracyclines, potency was compared, in terms of area under the curve. Differences in anthracycline monotherapy potency greater than 30% from 3 pairwise comparisons were identified in 28.3% of samples. Furthermore, different sensitivity was detected in 8.2% of patients comparing combinations of cytarabine and anthracyclines. A third of the patients could benefit from the use of this test in the first line induction therapy selection, although it should be confirmed in a clinical trial specifically designed. PB Mattioli 1885 SpA SN 2035-3006 YR 2019 FD 2019-03-01 LK http://hdl.handle.net/10668/13689 UL http://hdl.handle.net/10668/13689 LA en NO Megías-Vericat JE, Martínez-Cuadrón D, López JM, Bergua JM, Tormo M, Serrano J, et al. Differences in ex-vivo Chemosensitivity to Anthracyclines in First Line Acute Myeloid Leukemia. Mediterr J Hematol Infect Dis. 2019 Mar 1;11(1):e2019016 DS RISalud RD Sep 27, 2025