Відмінності між версіями «Le illness in peripheral blood or bone marrow even when»
м |
м |
||
| Рядок 1: | Рядок 1: | ||
| − | + | doi:ten.3324/haematol.2013.099796 The on the net version of this article has a Supplementary Appendix. Manuscript received on October 17, 2013. Manuscript accepted on December 31, 2013. Correspondence: jdelgado@clinic.ub.eshaematologica | 2014; 99(5)R. Santacruz et al.deletion [http://kfyst.com/comment/html/?257205.html Uring {the right|the proper|the correct|the best|the appropriate] possess a higher probability of remaining MRD-positive after therapy in comparison to individuals without this chromosome abnormality.18 For all these factors, current suggestions for the management of patients with CLL advocate MRD assessment only inside clinical trials with "curative intention".36 With all this facts in thoughts, we retrospectively evaluated the impact of MRD around the outcome of patients with CLL getting any front-line therapy in the context of a very detailed prognostic evaluation, including lately described recurrent gene mutations.survival and general survival have been calculated utilizing a landmark evaluation. All calculations had been performed employing either SPSS, version 18.0, or R, version three.0.1. Two-sided P values 0.05 were deemed statistically important. A detailed explanation on the statistical procedures is accessible in the On the web Supplement.Final results Baseline characteristicsThe median age from the complete cohort was 58 years (variety, 27-93 years), plus the percentage of sufferers older than 70 years was 22 . Based on D ner's hierarchical model, 17/221 (eight ) and 40/221 (18 ) individuals had 17p deletion and 11q deletion, respectively.Le illness in peripheral blood or bone marrow even when pretty sensitive immunophenotypic or molecular methods are utilised to appear for residual illness. These patients are regarded as to have achieved a minimal residual illness (MRD) adverse status.17-20 Various phase II trials have demonstrated that individuals achieving MRD negativity have a signif-icantly longer survival than people who remain MRD positive, and this really is accurate for patients treated with standard chemotherapy,21,22 monoclonal antibodies,23 chemoimmunotherapy,24 or stem cell transplantation.25,26 Additionally, a phase III trial performed by the German CLL Study Group (GCLLSG) not too long ago revealed that individuals acquiring MRD negativity had drastically longer progression-free and overall survivals, irrespectively with the treatment received.18 However, however, a few of these studies were flawed by inappropriate statistical analysis, especially the measurement of time-to-event outcomes from treatment initiation.27 In addition, there are many caveats towards the use of MRD evaluation in individuals with CLL.28 Initially, CLL remains incurable and at least 30 of individuals who obtain MRD negativity soon after front-line therapy with fludarabine-cyclophosphamide (FC) or rituximab-FC sooner or later encounter a disease relapse inside five years.18 Secondly, in contrast to the scenario in acute promyelocytic leukemia or chronic myeloid leukemia,29,30 there is certainly no formal proof of a therapeutic benefit of re-treatment upon documentation of MRD positivity immediately after an initial MRD-negative response in comparison to therapy at the time of clinical relapse. Actually, really few studies have demonstrated a clear benefit from MRD eradication or consolidation therapy in CLL,31,32 and a few from the methods tested, though efficient, resulted in substantial toxicity.33-35 Thirdly, it might be argued that MRD assessment is just a surrogate for evalution of other adverse prognostic markers because, as an illustration, sufferers having a 17p014 Ferrata Storti Foundation. | |
Версія за 08:33, 30 січня 2018
doi:ten.3324/haematol.2013.099796 The on the net version of this article has a Supplementary Appendix. Manuscript received on October 17, 2013. Manuscript accepted on December 31, 2013. Correspondence: jdelgado@clinic.ub.eshaematologica | 2014; 99(5)R. Santacruz et al.deletion Uring {the right|the proper|the correct|the best|the appropriate possess a higher probability of remaining MRD-positive after therapy in comparison to individuals without this chromosome abnormality.18 For all these factors, current suggestions for the management of patients with CLL advocate MRD assessment only inside clinical trials with "curative intention".36 With all this facts in thoughts, we retrospectively evaluated the impact of MRD around the outcome of patients with CLL getting any front-line therapy in the context of a very detailed prognostic evaluation, including lately described recurrent gene mutations.survival and general survival have been calculated utilizing a landmark evaluation. All calculations had been performed employing either SPSS, version 18.0, or R, version three.0.1. Two-sided P values 0.05 were deemed statistically important. A detailed explanation on the statistical procedures is accessible in the On the web Supplement.Final results Baseline characteristicsThe median age from the complete cohort was 58 years (variety, 27-93 years), plus the percentage of sufferers older than 70 years was 22 . Based on D ner's hierarchical model, 17/221 (eight ) and 40/221 (18 ) individuals had 17p deletion and 11q deletion, respectively.Le illness in peripheral blood or bone marrow even when pretty sensitive immunophenotypic or molecular methods are utilised to appear for residual illness. These patients are regarded as to have achieved a minimal residual illness (MRD) adverse status.17-20 Various phase II trials have demonstrated that individuals achieving MRD negativity have a signif-icantly longer survival than people who remain MRD positive, and this really is accurate for patients treated with standard chemotherapy,21,22 monoclonal antibodies,23 chemoimmunotherapy,24 or stem cell transplantation.25,26 Additionally, a phase III trial performed by the German CLL Study Group (GCLLSG) not too long ago revealed that individuals acquiring MRD negativity had drastically longer progression-free and overall survivals, irrespectively with the treatment received.18 However, however, a few of these studies were flawed by inappropriate statistical analysis, especially the measurement of time-to-event outcomes from treatment initiation.27 In addition, there are many caveats towards the use of MRD evaluation in individuals with CLL.28 Initially, CLL remains incurable and at least 30 of individuals who obtain MRD negativity soon after front-line therapy with fludarabine-cyclophosphamide (FC) or rituximab-FC sooner or later encounter a disease relapse inside five years.18 Secondly, in contrast to the scenario in acute promyelocytic leukemia or chronic myeloid leukemia,29,30 there is certainly no formal proof of a therapeutic benefit of re-treatment upon documentation of MRD positivity immediately after an initial MRD-negative response in comparison to therapy at the time of clinical relapse. Actually, really few studies have demonstrated a clear benefit from MRD eradication or consolidation therapy in CLL,31,32 and a few from the methods tested, though efficient, resulted in substantial toxicity.33-35 Thirdly, it might be argued that MRD assessment is just a surrogate for evalution of other adverse prognostic markers because, as an illustration, sufferers having a 17p014 Ferrata Storti Foundation.
