Publications by authors named "A F Gilkes"
Purpose: To evaluate the survival benefit of chemotherapy intensification in older patients with AML who have not achieved a measurable residual disease (MRD)-negative remission.
Methods: Five hundred twenty-three patients with AML (median age, 67 years; range, 51-79) without a flow cytometric MRD-negative remission response after a first course of daunorubicin and AraC (DA; including 165 not in remission) were randomly assigned between up to two further courses of DA or intensified chemotherapy-either fludarabine, cytarabine, granulocyte colony-stimulating factor and idarubicin (FLAG-Ida) or DA with cladribine (DAC).
Results: Overall survival (OS) was not improved in the intensification arms (DAC DA: hazard ratio [HR], 0.
Article Synopsis
- - The study focuses on older patients (over 60 years) with acute myeloid leukemia (AML) and aims to create a prognostic model to identify those who would benefit from intensive chemotherapy and stem cell transplantation.
- - Researchers analyzed data from 1,910 patients, using a random survival forest to evaluate clinical and genetic factors associated with overall survival, resulting in the identification of four distinct survival groups based on nine variables.
- - The newly developed AML60+ classification shows improved prognostic accuracy and indicates that intermediate- and very poor-risk patients may benefit from allogeneic hematopoietic cell transplantation, potentially guiding treatment decisions for older adults with AML.
Article Synopsis
- NPM1-mutated acute myeloid leukemia (AML) has a generally good prognosis, but many patients still relapse, and traditional risk factors only include FLT3-ITD mutations and adverse karyotypes due to inconsistent findings from other factors.* -
- A study involving 1,357 patients revealed that specific mutations (FLT3-ITD, DNMT3A, WT1, and certain NPM1 mutations) correlate with poorer overall survival and are linked to measurable residual disease (MRD) status.* -
- Intensified chemotherapy using the FLAG-Ida regimen showed better outcomes across all patient subgroups, with particularly notable improvements for those in high-risk molecular categories.*
Selection of patients with NPM1-mutated acute myeloid leukemia (AML) for allogeneic transplant in first complete remission (CR1-allo) remains controversial because of a lack of robust data. Consequently, some centers consider baseline FLT3-internal tandem duplication (ITD) an indication for transplant, and others rely on measurable residual disease (MRD) status. Using prospective data from the United Kingdom National Cancer Research Institute AML17 and AML19 studies, we examined the impact of CR1-allo according to peripheral blood NPM1 MRD status measured by quantitative reverse transcription polymerase chain reaction after 2 courses of induction chemotherapy.
View Article and Find Full Text PDFThis case presentation involves an elderly patient presenting with signs of severe anemia. Investigations lead to the detection of Cameron lesions within a large paraesophageal hiatus hernia (HH). These lesions have been described in the literature as being an incidental finding within the herniated stomach during endoscopy in patients with large HH who presented with microcytic hypochromic anemia.
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