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Mannelli F, Gianfaldoni G, Guglielmelli P, Buccisano F, Caporale R, Chiarini M, Rossi G, Venditti A, Fazi P, Crea E, Piciocchi A, Voso MT, Vignetti M, Amadori S, Vannucchi AM. AMELIORATE: early intensification in FLT3-mutated acute myeloid leukemia based on peripheral blast clearance - MYNERVA-GIMEMA AML1919 trial. Future Oncol 2021; 17:3787-3796. [PMID: 34254530 DOI: 10.2217/fon-2021-0388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AMELIORATE is a Phase III, randomized trial aiming to personalize treatment intensity in FLT3-mutated acute myeloid leukemia. The current study provides an early appraisal of chemosensitivity based on peripheral blasts clearance, as assessed by multiparameter flow cytometry, from baseline to day 4 of induction. This biomarker was previously demonstrated to predict complete remission achievement and measurable residual disease status. For patients experiencing low peripheral blast cells (i.e., ≤2.0 logs), two major adjustments of treatment as compared with current standard of care are envisioned in the experimental arm: the immediate switch to intensified induction with high-doses cytarabine (1500 mg/m2 b.i.d. on days 5-7 of induction); and the early allocation of the patient to high-risk disease category, to be further refined later based on postinduction measurable residual disease status.
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Affiliation(s)
- Francesco Mannelli
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
| | | | - Paola Guglielmelli
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
| | - Francesco Buccisano
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | - Roberto Caporale
- Centro Diagnostico di Citofluorimetria e Immunoterapia, AOU Careggi, Firenze 50134, Italy
| | - Marco Chiarini
- Laboratorio di Citofluorimetria; Dipartimento di Diagnostica di Laboratorio, Spedali Civili, Brescia 25121, Italy
| | - Giuseppe Rossi
- Divisione di Ematologia, Spedali Civili, Brescia 25121, Italy
| | - Adriano Venditti
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | | | | | | | - Maria Teresa Voso
- Ematologia, Dipartimento di Biomedicina e Prevenzione, Università di Tor Vergata, Roma 00133, Italy.,Fondazione Policlinico Tor Vergata, Roma 00133, Italy
| | | | | | - Alessandro Maria Vannucchi
- SOD Ematologia, AOU Careggi, Firenze 50134, Italy.,Centro Ricerca e Innovazione Malattie Mieloproliferative (CRIMM), AOU Careggi, Firenze 50134, Italy
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