Efficacy of Induction Treatments in Patients with Biphenotypic Acute Leukemia

İbrahim Halil Açar; Birol Güvenç

Makale detayları

Efficacy of Induction Treatments in Patients with Biphenotypic Acute Leukemia

Yazarlar:

İbrahim Halil Açar | Birol Güvenç

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

İç Hastalıkları

Dergi:

Black Sea Journal of Health Science Vol.6 Issue 4, pp.713-718

Belge Tipi:

Makale

Yayın Tarihi:

10/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001290968

pISSN:

2619-9041

Anahtar kelimeler:

Özet:

 Despite advances in leukemia diagnosis and treatment, BAL management remains challenging. The aim of this study is to contribute to the literature by analyzing the clino-pathological characteristics and treatment outcome of 13 patients diagnosed as BAL. Medical charts of 13 patients who were diagnosed as BAL according to EGIL or WHO 2016 criteria in our center between 2017- 2022 were retrospectively reviewed. Of the 13 BAL patients with a mean age of 36, 6 46 were female and 7 54 were male. Eleven 84.6 of the cases showed Bmyeloid, 2 15.6 Tmyeloid cell expression patterns. In cytogenetic examination, 3 23.1 of the cases had tv; 11q23 MLL, 1 7.7 t9;22 BCR-ABL1 and 1 7.7 FLT- ITD abnormality. Eight of the cases 61.5 received ALL induction therapy and 5 38.5 of them received AML induction therapy, and 8 61.5 of them responded to the treatment. The treatment protocols with the highest rate of response to treatment were ALLOLD07 100, S-HAM 75 and HYPER-CVAD 66, respectively. Median follow-up from the time of diagnosis was 32 months range: 2-71, median OS 9 months 95CI: 2.71-15.94 and the median PFS 4.5 months 95CI: 3.32-5.67. Allo-Hematopoietic stem cell transplantation HSCT was performed in 8 of the cases. After HSCT, 1 patient developed relapsed disease and died from disease progression. Four of the cases died due to BAL progression, 2 died due to infection, and the overall survival rate was 53.8. Since BAL is a rare disease, there is no consensus on which treatment is optimal. Although ALL-based induction regimens seem to be superior in the treatment of BAL, multicenter clinical studies with more cases are needed to better understand the heterogeneous nature of this rare disease.

 Despite advances in leukemia diagnosis and treatment, BAL management remains challenging. The aim of this study is to contribute to the literature by analyzing the clino-pathological characteristics and treatment outcome of 13 patients diagnosed as BAL. Medical charts of 13 patients who were diagnosed as BAL according to EGIL or WHO 2016 criteria in our center between 2017- 2022 were retrospectively reviewed. Of the 13 BAL patients with a mean age of 36, 6 46 were female and 7 54 were male. Eleven 84.6 of the cases showed Bmyeloid, 2 15.6 Tmyeloid cell expression patterns. In cytogenetic examination, 3 23.1 of the cases had tv; 11q23 MLL, 1 7.7 t9;22 BCR-ABL1 and 1 7.7 FLT- ITD abnormality. Eight of the cases 61.5 received ALL induction therapy and 5 38.5 of them received AML induction therapy, and 8 61.5 of them responded to the treatment. The treatment protocols with the highest rate of response to treatment were ALLOLD07 100, S-HAM 75 and HYPER-CVAD 66, respectively. Median follow-up from the time of diagnosis was 32 months range: 2-71, median OS 9 months 95CI: 2.71-15.94 and the median PFS 4.5 months 95CI: 3.32-5.67. Allo-Hematopoietic stem cell transplantation HSCT was performed in 8 of the cases. After HSCT, 1 patient developed relapsed disease and died from disease progression. Four of the cases died due to BAL progression, 2 died due to infection, and the overall survival rate was 53.8. Since BAL is a rare disease, there is no consensus on which treatment is optimal. Although ALL-based induction regimens seem to be superior in the treatment of BAL, multicenter clinical studies with more cases are needed to better understand the heterogeneous nature of this rare disease.

 Despite advances in leukemia diagnosis and treatment, BAL management remains challenging. The aim of this study is to contribute to the literature by analyzing the clino-pathological characteristics and treatment outcome of 13 patients diagnosed as BAL. Medical charts of 13 patients who were diagnosed as BAL according to EGIL or WHO 2016 criteria in our center between 2017- 2022 were retrospectively reviewed. Of the 13 BAL patients with a mean age of 36, 6 46 were female and 7 54 were male. Eleven 84.6 of the cases showed Bmyeloid, 2 15.6 Tmyeloid cell expression patterns. In cytogenetic examination, 3 23.1 of the cases had tv; 11q23 MLL, 1 7.7 t9;22 BCR-ABL1 and 1 7.7 FLT- ITD abnormality. Eight of the cases 61.5 received ALL induction therapy and 5 38.5 of them received AML induction therapy, and 8 61.5 of them responded to the treatment. The treatment protocols with the highest rate of response to treatment were ALLOLD07 100, S-HAM 75 and HYPER-CVAD 66, respectively. Median follow-up from the time of diagnosis was 32 months range: 2-71, median OS 9 months 95CI: 2.71-15.94 and the median PFS 4.5 months 95CI: 3.32-5.67. Allo-Hematopoietic stem cell transplantation HSCT was performed in 8 of the cases. After HSCT, 1 patient developed relapsed disease and died from disease progression. Four of the cases died due to BAL progression, 2 died due to infection, and the overall survival rate was 53.8. Since BAL is a rare disease, there is no consensus on which treatment is optimal. Although ALL-based induction regimens seem to be superior in the treatment of BAL, multicenter clinical studies with more cases are needed to better understand the heterogeneous nature of this rare disease.

 Lösemi tanı ve tedavisindeki ilerlemelere rağmen BAL yönetimi zorlu kalmaya devam etmektedir. Bu çalışmanın amacı BAL tanısı alan 13 hastanın klinokopatolojik özelliklerini ve tedavi sonuçlarını analiz edip literatüre katkıda bulunmaktır. Merkezimizde 2017-2022 yılları arasında EGIL veya WHO 2016 kriterlerine göre BAL tanısı alan 13 hastanın tıbbi kayıtları geriye dönük olarak incelendi. Ortalama yaşları 36 olan 13 BAL hastasının 6sı 46 kadın 7si 54 erkekti. Olguların 11i 84,6 myeloidB, 2si 15,6 myeloidT hücre ekspresyon paterni sergiliyordu. Sitogenetik incelemede olguların 3ünde 23,1 tv;11q23 MLL, 1inde 7,7 t9;22 BCR-ABL1 ve 1inde 7,7 FLT-ITD anomalisi mevcuttu. Olguların 7si 53 ALL ve 6sı 47 AML indüksiyon tedavisi aldı ve 8inde 61,5 tedaviye yanıt vardı. Tedaviye yanıt oranının en fazla olduğu protokoller sırasıyla ALLOLD07 100, S-HAM 75 ve HYPER-CVAD 66 idi. Tanı anından itibaren medyan takip süresi 32 ay aralık: 2-71, medyan OS 9 ay 95 CI: 2,71-15,94 ve medyan PFS ise 4.5 ay 95 CI: 3,32-5,67 idi. Olguların 8ine allojenik hematopoietik kök hücre transplantasyonu AKİT yapıldı. AKİT sonrası 1 hastada relaps hastalık gelişti ve hastalık progresyonundan öldü. Olguların 4ü BAL progresyonu, 2si enfeksiyon sebebiyle öldü ve genel sağkalım oranı 53.8 idi. BAL nadir görülen bir hastalık olduğundan optimal tedavinin ne olduğu konusunda ortak bir görüş yoktur. BAL tedavisinde ALL tabanlı indüksiyon rejimleri daha üstün gibi görünmekle beraber, bu nadir hastalığın heterojen doğasını anlamak için daha fazla olguyla yapılacak çok merkezli klinik çalışmalara ihtiyaç vardır.

Makale detayları

Efficacy of Induction Treatments in Patients with Biphenotypic Acute Leukemia

Yazarlar:

İbrahim Halil Açar | Birol Güvenç

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

İç Hastalıkları

Dergi:

Black Sea Journal of Health Science Vol.6 Issue 4, pp.713-718

Belge Tipi:

Makale

Yayın Tarihi:

10/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001290968

pISSN:

2619-9041

Biphenotypic leukemia

Survival

PrognosisBifenotipik lösemi

Sağkalım

Prognoz

Sayı

Makale detayları

Efficacy of Induction Treatments in Patients with Biphenotypic Acute Leukemia

Yazarlar: İbrahim Halil Açar | Birol Güvenç

Yayıncı: Karyay Karadeniz Yayımcılık

Ana Başlıklar: İç Hastalıkları

Dergi: Black Sea Journal of Health Science Vol.6 Issue 4, pp.713-718

Belge Tipi: Makale

Yayın Tarihi: 10/2023

Belge Dili: Türkçe

Document ID (Org No.): 2001290968

pISSN: 2619-9041

Biphenotypic leukemia

Survival

PrognosisBifenotipik lösemi

Sağkalım

Prognoz

Sayı

Yazarlar:

İbrahim Halil Açar | Birol Güvenç

Yayıncı:

Karyay Karadeniz Yayımcılık

Ana Başlıklar:

İç Hastalıkları

Dergi:

Black Sea Journal of Health Science Vol.6 Issue 4, pp.713-718

Belge Tipi:

Makale

Yayın Tarihi:

10/2023

Belge Dili:

Türkçe

Document ID (Org No.):

2001290968

pISSN:

2619-9041