Difference between revisions of "Acute myeloid leukemia, NPM1-mutated"

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{{#lst:Section editor transclusions|aml}}
 
{{#lst:Section editor transclusions|aml}}
 
<big>'''Note: these are regimens tested in biomarker-specific populations for patients with NPM1-mutated AML, please see the [[Acute myeloid leukemia|main AML page]] for other regimens.'''</big>
 
<big>'''Note: these are regimens tested in biomarker-specific populations for patients with NPM1-mutated AML, please see the [[Acute myeloid leukemia|main AML page]] for other regimens.'''</big>
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{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
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=Guidelines=
 
=Guidelines=
 
=="How I Treat"==
 
=="How I Treat"==
 
*'''2021:''' Falini et al. [https://doi.org/10.1182/blood.2020008211 How I diagnose and treat NPM1-mutated AML]
 
*'''2021:''' Falini et al. [https://doi.org/10.1182/blood.2020008211 How I diagnose and treat NPM1-mutated AML]
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=Upfront induction therapy=
 
=Upfront induction therapy=
 
==Cytarabine & Etoposide {{#subobject:e8gacb|Regimen=1}}==
 
==Cytarabine & Etoposide {{#subobject:e8gacb|Regimen=1}}==
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<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:15hvdd|Variant=1}}===
 
===Regimen {{#subobject:15hvdd|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
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|-
 
|-
 
|}
 
|}
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''To be completed''
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<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Cytarabine (Ara-C)]]
 
*[[Cytarabine (Ara-C)]]
 
*[[Etoposide (Vepesid)]]
 
*[[Etoposide (Vepesid)]]
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+
</div></div>
 
===References===
 
===References===
 
#'''AMLSG 15-10:''' NCT01237808
 
#'''AMLSG 15-10:''' NCT01237808
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==ICE & ATRA {{#subobject:e82156|Regimen=1}}==
 
==ICE & ATRA {{#subobject:e82156|Regimen=1}}==
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ICE & ATRA: '''<u>I</u>'''darubicin, '''<u>C</u>'''ytarabine, '''<u>E</u>'''toposide, '''<u>A</u>'''ll-'''<u>T</u>'''rans '''<u>R</u>'''etinoic '''<u>A</u>'''cid
 
ICE & ATRA: '''<u>I</u>'''darubicin, '''<u>C</u>'''ytarabine, '''<u>E</u>'''toposide, '''<u>A</u>'''ll-'''<u>T</u>'''rans '''<u>R</u>'''etinoic '''<u>A</u>'''cid
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<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #1, 60 or younger {{#subobject:cf53dd|Variant=1}}===
 
===Regimen variant #1, 60 or younger {{#subobject:cf53dd|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
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|-
 
|-
 
|}
 
|}
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''To be completed''
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<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Idarubicin (Idamycin)]] as follows:
 
*[[Idarubicin (Idamycin)]] as follows:
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====Targeted therapy====
 
====Targeted therapy====
 
*[[All-trans retinoic acid (ATRA)]] 45 mg/m<sup>2</sup>/day PO on days 6 to 8, then 15 mg/m<sup>2</sup>/day PO on days 9 to 21
 
*[[All-trans retinoic acid (ATRA)]] 45 mg/m<sup>2</sup>/day PO on days 6 to 8, then 15 mg/m<sup>2</sup>/day PO on days 9 to 21
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'''2 cycles'''
 
'''2 cycles'''
 +
</div>
 +
<div class="toccolours" style="background-color:#cbd5e7">
 
====Subsequent treatment====
 
====Subsequent treatment====
 
*[[#HiDAC_.26_ATRA_88|HiDAC & ATRA]] consolidation
 
*[[#HiDAC_.26_ATRA_88|HiDAC & ATRA]] consolidation
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+
</div></div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen variant #2, older than 60 {{#subobject:cfghcd|Variant=1}}===
 
===Regimen variant #2, older than 60 {{#subobject:cfghcd|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
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|-
 
|-
 
|}
 
|}
−
''To be completed''
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<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Idarubicin (Idamycin)]] 12 mg/m<sup>2</sup> IV once per day on days 1 & 3
 
*[[Idarubicin (Idamycin)]] 12 mg/m<sup>2</sup> IV once per day on days 1 & 3
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====Targeted therapy====
 
====Targeted therapy====
 
*[[All-trans retinoic acid (ATRA)]] 45 mg/m<sup>2</sup>/day PO on days 6 to 8, then 15 mg/m<sup>2</sup>/day PO on days 9 to 21
 
*[[All-trans retinoic acid (ATRA)]] 45 mg/m<sup>2</sup>/day PO on days 6 to 8, then 15 mg/m<sup>2</sup>/day PO on days 9 to 21
−
 
 
'''2 cycles'''
 
'''2 cycles'''
 +
</div>
 +
<div class="toccolours" style="background-color:#cbd5e7">
 
====Subsequent treatment====
 
====Subsequent treatment====
 
*[[#HiDAC_.26_ATRA_88|HiDAC & ATRA]] consolidation
 
*[[#HiDAC_.26_ATRA_88|HiDAC & ATRA]] consolidation
−
 
+
</div></div>
 
===References===
 
===References===
 
# '''AMLSG 09-09:''' Schlenk RF, Paschka P, Krzykalla J, Weber D, Kapp-Schwoerer S, Gaidzik VI, Leis C, Fiedler W, Kindler T, Schroeder T, Mayer K, Lübbert M, Wattad M, Götze K, Horst HA, Koller E, Wulf G, Schleicher J, Bentz M, Greil R, Hertenstein B, Krauter J, Martens U, Nachbaur D, Abu Samra M, Girschikofsky M, Basara N, Benner A, Thol F, Heuser M, Ganser A, Döhner K, Döhner H. Gemtuzumab Ozogamicin in NPM1-Mutated Acute Myeloid Leukemia: Early Results From the Prospective Randomized AMLSG 09-09 Phase III Study. J Clin Oncol. 2020 Feb 20;38(6):623-632. Epub 2019 Dec 18. [https://doi.org/10.1200/JCO.19.01406 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7030890/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/31851556 PubMed] NCT00893399
 
# '''AMLSG 09-09:''' Schlenk RF, Paschka P, Krzykalla J, Weber D, Kapp-Schwoerer S, Gaidzik VI, Leis C, Fiedler W, Kindler T, Schroeder T, Mayer K, Lübbert M, Wattad M, Götze K, Horst HA, Koller E, Wulf G, Schleicher J, Bentz M, Greil R, Hertenstein B, Krauter J, Martens U, Nachbaur D, Abu Samra M, Girschikofsky M, Basara N, Benner A, Thol F, Heuser M, Ganser A, Döhner K, Döhner H. Gemtuzumab Ozogamicin in NPM1-Mutated Acute Myeloid Leukemia: Early Results From the Prospective Randomized AMLSG 09-09 Phase III Study. J Clin Oncol. 2020 Feb 20;38(6):623-632. Epub 2019 Dec 18. [https://doi.org/10.1200/JCO.19.01406 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7030890/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/31851556 PubMed] NCT00893399
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[[Category:Acute myeloid leukemia regimens]]
 
[[Category:Acute myeloid leukemia regimens]]
 
[[Category:Biomarker-specific pages]]
 
[[Category:Biomarker-specific pages]]
 
[[Category:Acute leukemias]]
 
[[Category:Acute leukemias]]

Revision as of 13:13, 28 February 2023

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Section editor transclusions Note: these are regimens tested in biomarker-specific populations for patients with NPM1-mutated AML, please see the main AML page for other regimens.

3 regimens on this page
4 variants on this page


Guidelines

"How I Treat"

Upfront induction therapy

Cytarabine & Etoposide

Regimen

Study Years of enrollment Evidence Comparator Comparative Efficacy
Awaiting publication (AMLSG 15-10) 2011-NR Phase 3 (C) ATRA, Cytarabine, Etoposide Not available

Chemotherapy

References

  1. AMLSG 15-10: NCT01237808

ICE & ATRA

ICE & ATRA: Idarubicin, Cytarabine, Etoposide, All-Trans Retinoic Acid

Regimen variant #1, 60 or younger

Study Years of enrollment Evidence Comparator Comparative Efficacy
Schlenk et al. 2019 (AMLSG 09-09) 2010-2017 Phase 3 (C) ICE, ATRA, GO Did not meet primary endpoint of EFS

Chemotherapy

  • Idarubicin (Idamycin) as follows:
    • Cycle 1: 12 mg/m2 IV once per day on days 1, 3, 5
    • Cycle 2: 12 mg/m2 IV once per day on days 1 & 3
  • Cytarabine (Ara-C) 100 mg/m2/day IV continuous infusion over 7 days, started on day 1 (total dose per cycle: 700 mg/m2)
  • Etoposide (Vepesid) as follows:
    • Cycle 1: 100 mg/m2 IV once per day on days 1 to 3
    • Cycle 2: 100 mg/m2 IV once per day on days 1 & 3

Targeted therapy

2 cycles

Subsequent treatment


Regimen variant #2, older than 60

Study Years of enrollment Evidence Comparator Comparative Efficacy
Schlenk et al. 2019 (AMLSG 09-09) 2010-2017 Phase 3 (C) ICE, ATRA, GO Did not meet primary endpoint of EFS

Chemotherapy

Targeted therapy

2 cycles

Subsequent treatment

References

  1. AMLSG 09-09: Schlenk RF, Paschka P, Krzykalla J, Weber D, Kapp-Schwoerer S, Gaidzik VI, Leis C, Fiedler W, Kindler T, Schroeder T, Mayer K, Lübbert M, Wattad M, Götze K, Horst HA, Koller E, Wulf G, Schleicher J, Bentz M, Greil R, Hertenstein B, Krauter J, Martens U, Nachbaur D, Abu Samra M, Girschikofsky M, Basara N, Benner A, Thol F, Heuser M, Ganser A, Döhner K, Döhner H. Gemtuzumab Ozogamicin in NPM1-Mutated Acute Myeloid Leukemia: Early Results From the Prospective Randomized AMLSG 09-09 Phase III Study. J Clin Oncol. 2020 Feb 20;38(6):623-632. Epub 2019 Dec 18. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00893399
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