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Tam CS, Anderson MA, Pott C, Agarwal R, Handunnetti S, Hicks RJ, Burbury K, Turner G, Di Iulio J, Bressel M, Westerman D, Lade S, Dreyling M, Dawson SJ, Dawson MA, Seymour JF, Roberts AW. Ibrutinib plus Venetoclax for the Treatment of Mantle-Cell Lymphoma. N Engl J Med 2018; 378:1211-1223. [PMID: 29590547 DOI: 10.1056/nejmoa1715519] [Citation(s) in RCA: 291] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Both the BTK inhibitor ibrutinib and the BCL2 inhibitor venetoclax are active as monotherapy in the treatment of mantle-cell lymphoma. Complete response rates of 21% have been observed for each agent when administered as long-term continuous therapy. Preclinical models predict synergy in combination. METHODS We conducted a single-group, phase 2 study of daily oral ibrutinib and venetoclax in patients, as compared with historical controls. Patients commenced ibrutinib monotherapy at a dose of 560 mg per day. After 4 weeks, venetoclax was added in stepwise, weekly increasing doses to 400 mg per day. Both drugs were continued until progression or an unacceptable level of adverse events. The primary end point was the rate of complete response at week 16. Minimal residual disease (MRD) was assessed by flow cytometry in bone marrow and by allele-specific oligonucleotide-polymerase chain reaction (ASO-PCR) in blood. RESULTS The study included 24 patients with relapsed or refractory mantle-cell lymphoma (23 patients) or previously untreated mantle-cell lymphoma (1 patient). Patients were 47 to 81 years of age, and the number of previous treatments ranged from none to six. Half the patients had aberrations of TP53, and 75% had a high-risk prognostic score. The complete response rate according to computed tomography at week 16 was 42%, which was higher than the historical result of 9% at this time point with ibrutinib monotherapy (P<0.001). The rate of complete response as assessed by positron-emission tomography was 62% at week 16 and 71% overall. MRD clearance was confirmed by flow cytometry in 67% of the patients and by ASO-PCR in 38%. In a time-to-event analysis, 78% of the patients with a response were estimated to have an ongoing response at 15 months. The tumor lysis syndrome occurred in 2 patients. Common side effects were generally low grade and included diarrhea (in 83% of the patients), fatigue (in 75%), and nausea or vomiting (in 71%). CONCLUSIONS In this study involving historical controls, dual targeting of BTK and BCL2 with ibrutinib and venetoclax was consistent with improved outcomes in patients with mantle-cell lymphoma who had been predicted to have poor outcomes with current therapy. (Funded by Janssen and others; AIM ClinicalTrials.gov number, NCT02471391 .).
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Affiliation(s)
- Constantine S Tam
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Mary Ann Anderson
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Christiane Pott
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Rishu Agarwal
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Sasanka Handunnetti
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Rodney J Hicks
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Kate Burbury
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Gillian Turner
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Juliana Di Iulio
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Mathias Bressel
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - David Westerman
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Stephen Lade
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Martin Dreyling
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Sarah-Jane Dawson
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Mark A Dawson
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - John F Seymour
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
| | - Andrew W Roberts
- From the Peter MacCallum Cancer Centre, Melbourne, VIC (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., G.T., J.D.I., M.B., D.W., S.L., S.-J.D., M.A.D., J.F.S., A.W.R.), and the Victorian Comprehensive Cancer Centre (C.S.T., M.A.A., R.A., S.H., R.J.H., K.B., D.W., S.-J.D., M.A.D., J.F.S., A.W.R.), the Faculty of Medicine (C.S.T., R.J.H., S.-J.D., M.A.D., J.F.S., A.W.R.) and Centre for Cancer Research (S.-J.D., M.A.D.), University of Melbourne, the Department of Clinical Haematology and Bone Marrow Transplantation, the Royal Melbourne Hospital (C.S.T., M.A.A., K.B., J.F.S., A.W.R.), and the Division of Cancer and Haematology, Walter and Eliza Hall Institute of Medical Research (M.A.A., A.W.R.), Parkville, VIC - all in Australia; and the University Hospital of Schleswig-Holstein, Kiel (C.P.), and Klinikum der Universität, Ludwig-Maximilian University of Munich, Munich (M.D.) - both in Germany
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Bradstock KF, Link E, Di Iulio J, Szer J, Marlton P, Wei AH, Enno A, Schwarer A, Lewis ID, D'Rozario J, Coyle L, Cull G, Campbell P, Leahy MF, Hahn U, Cannell P, Tiley C, Lowenthal RM, Moore J, Cartwright K, Cunningham I, Taper J, Grigg A, Roberts AW, Benson W, Hertzberg M, Deveridge S, Rowlings P, Mills AK, Gill D, Bardy P, Campbell L, Seymour JF. Idarubicin Dose Escalation During Consolidation Therapy for Adult Acute Myeloid Leukemia. J Clin Oncol 2017; 35:1678-1685. [PMID: 28368672 DOI: 10.1200/jco.2016.70.6374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Purpose Higher doses of the anthracycline daunorubicin during induction therapy for acute myeloid leukemia (AML) have been shown to improve remission rates and survival. We hypothesized that improvements in outcomes in adult AML may be further achieved by increased anthracycline dose during consolidation therapy. Patients and Methods Patients with AML in complete remission after induction therapy were randomly assigned to receive two cycles of consolidation therapy with cytarabine 100 mg/m2 daily for 5 days, etoposide 75 mg/m2 daily for 5 days, and idarubicin 9 mg/m2 daily for either 2 or 3 days (standard and intensive arms, respectively). The primary end point was leukemia-free survival (LFS). Results Two hundred ninety-three patients 16 to 60 years of age, excluding those with core binding factor AML and acute promyelocytic leukemia, were randomly assigned to treatment groups (146 to the standard arm and 147 to the intensive arm). Both groups were balanced for age, karyotypic risk, and FLT3-internal tandem duplication and NPM1 gene mutations. One hundred twenty patients in the standard arm (82%) and 95 patients in the intensive arm (65%) completed planned consolidation ( P < .001). Durations of severe neutropenia and thrombocytopenia were prolonged in the intensive arm, but there were no differences in serious nonhematological toxicities. With a median follow-up of 5.3 years (range, 0.6 to 9.9 years), there was a statistically significant improvement in LFS in the intensive arm compared with the standard arm (3-year LFS, 47% [95% CI, 40% to 56%] v 35% [95% CI, 28% to 44%]; P = .045). At 5 years, the overall survival rate was 57% in the intensive arm and 47% in the standard arm ( P = .092). There was no evidence of selective benefit of intensive consolidation within the cytogenetic or FLT3-internal tandem duplication and NPM1 gene mutation subgroups. Conclusion An increased cumulative dose of idarubicin during consolidation therapy for adult AML resulted in improved LFS, without increased nonhematologic toxicity.
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Affiliation(s)
- Kenneth F Bradstock
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Emma Link
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Juliana Di Iulio
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Jeff Szer
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Paula Marlton
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Andrew H Wei
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Arno Enno
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Anthony Schwarer
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Ian D Lewis
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - James D'Rozario
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Luke Coyle
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Gavin Cull
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Phillip Campbell
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Michael F Leahy
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Uwe Hahn
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Paul Cannell
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Campbell Tiley
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Ray M Lowenthal
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - John Moore
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Kimberly Cartwright
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Ilona Cunningham
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - John Taper
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Andrew Grigg
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Andrew W Roberts
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Warwick Benson
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Mark Hertzberg
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Sandra Deveridge
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Philip Rowlings
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Anthony K Mills
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Devinder Gill
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Peter Bardy
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Lynda Campbell
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
| | - John F Seymour
- Kenneth F. Bradstock and Warwick Benson, Westmead Hospital, University of Sydney; Arno Enno, Sandra Deveridge, and Philip Rowlings, Calvary Mater Newcastle Hospital, Newcastle; Luke Coyle, Royal North Shore Hospital, St Leonards; Campbell Tiley, Central Coast Health, Gosford; John Moore, St Vincent's Hospital; Mark Hertzberg, Prince of Wales Hospital, Sydney; Kimberly Cartwright, Wollongong Hospital, Wollongong; Ilona Cunningham, Concord Repatriation General Hospital, Concord; John Taper, Nepean Hospital, Penrith, New South Wales; Emma Link, Juliana Di Iulio, and John F. Seymour, Peter MacCallum Cancer Centre; Jeff Szer, Andrew Grigg, Andrew W. Roberts, and John F. Seymour, University of Melbourne; Andrew H. Wei, Monash University; Anthony Schwarer, Box Hill Hospital; Lynda Campbell, Victorian Cancer Cytogenetics Service, Melbourne; Jeff Szer, Andrew Grigg, and Andrew W. Roberts, Royal Melbourne Hospital, Parkville; Phillip Campbell, Deakin University School of Medicine, Geelong, Victoria; Paula Marlton, Anthony K. Mills, and Devinder Gill, University of Queensland, Brisbane, Queensland; Ray M. Lowenthal, University of Tasmania, Hobart, Tasmania; Ian D. Lewis and Peter Bardy, Royal Adelaide Hospital; Uwe Hahn, Queen Elizabeth Hospital, Adelaide, South Australia; James D'Rozario, The Canberra Hospital, Garran, Canberra, Australia Capital Territory; Gavin Cull, Sir Charles Gairdner Hospital; Michael F. Leahy, University of Western Australia; and Paul Cannell, Royal Perth Hospital, Perth, Western Australia, Australia
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