A simple, robust, validated and highly predictive index for the determination of risk‐directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trial

@article{Wheatley1999ASR,
  title={A simple, robust, validated and highly predictive index for the determination of risk‐directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trial},
  author={Keith Wheatley and Alan K Burnett and A. H. Goldstone and Richard Gray and Ian M. Hann and Christine J Harrison and J. K. H. Rees and Richard F. Stevens and Helen Walker},
  journal={British Journal of Haematology},
  year={1999},
  volume={107}
}
Data on 1711 patients, aged up to 55 years, in the MRC AML 10 trial were used to create a prognostic index for use in risk‐directed therapy decision making for younger patients with acute myeloid leukaemia (AML). Two parameters, response after course 1 and cytogenetics, were strongly predictive of outcome. For patients with complete remission, partial remission and resistant disease, 5‐year survival from the start of course 2 was 53%, 44% and 22% and relapse rates were 46%, 48% and 69… Expand
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References

SHOWING 1-10 OF 31 REFERENCES
The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties.
TLDR
Subgroup analysis demonstrated that the three cytogenetically defined prognostic groups retained their predictive value in the context of secondary as well as de novo AML, within the pediatric age group and furthermore were found to be a key determinant of outcome from autologous or allogeneic bone marrow transplantation (BMT) in first CR. Expand
P‐glycoprotein expression on acute myeloid leukaemia blast cells at diagnosis predicts response to chemotherapy and survival
TLDR
The results confirm the prognostic value of Pgp expression in AML at diagnosis and suggest that Pgp could be a useful therapeutic target for reversing multi‐drug resistance. Expand
Establishing the presence of the t( 15; 17) in suspected acute promyelocytic leukaemia: cytogenetic, molecular and PML immunofluorescence assessment of patients entered into the M.R.C. ATRA trial
TLDR
Although PML immunofluorescence staining is suitable for rapid determination of patients likely to benefit from ATRA, this approach does not obviate the need for cytogenetic and RT-PCR analysis of all patients entered into APL clinical trials, because both techniques provide additional information which may prove to be of independent prognostic significance. Expand
Randomized comparison of DAT versus ADE as induction chemotherapy in children and younger adults with acute myeloid leukemia. Results of the Medical Research Council's 10th AML trial (MRC AML10). Adult and Childhood Leukaemia Working Parties of the Medical Research Council.
TLDR
DAT and ADE both achieve high remission rates and good long-term survival, and are equally effective chemotherapy regimens for the treatment of AML patients aged up to 55 years. Expand
Report of the National Cancer Institute-sponsored workshop on definitions of diagnosis and response in acute myeloid leukemia.
TLDR
The National Cancer Institute sponsored a workshop to develop a set of standardized diagnostic and response criteria for acute myeloid leukemia (AML) clinical trials, and definitions of response for clinical trials are presented to facilitate comparisons among different studies. Expand
Randomised comparison of addition of autologous bone-marrow transplantation to intensive chemotherapy for acute myeloid leukaemia in first remission: results of MRC AML 10 trial
TLDR
The addition of autologous BMT to four courses of intensive chemotherapy substantially reduces the risk of relapse in all risk groups, leading to improvement in long-term survival. Expand
Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chemotherapy: a cross-sectional study of the EORTC-GIMEMA AML 8A trial
TLDR
Results, confirming a higher risk of permanent impairment of QOL after BMT, may have an impact on medical decisions and warrant further studies. Expand
Expression of the multidrug resistance-associated protein (MRP) in acute leukaemia.
TLDR
The results suggest that MRP expression may be of prognostic importance in AML but the significance of the increased levels detected remain unclear. Expand
Effect of all transretinoic acid in newly diagnosed acute promyelocytic leukemia. Results of a multicenter randomized trial. European APL 91 Group
TLDR
It is strongly suggested that ATRA should be incorporated in the front line therapy of newly diagnosed APL, as EFS was significantly higher in the ATRA group than in the chemotherapy group. Expand
Proposals for the Classification of the Acute Leukaemias French‐American‐British (FAB) Co‐operative Group
Summary. A uniform system of classification and nomenclature of the acute leukaemias, at present lacking, should permit more accurate recording of the distribution of cases entered into clinicalExpand
...
1
2
3
4
...