{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T05:26:18Z","timestamp":1789881978112,"version":"4.0.1"},"reference-count":23,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,30]],"date-time":"2013-05-30T00:00:00Z","timestamp":1369872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:p>Despite progress in the understanding of leukemia pathophysiology, the treatment of acute myeloid leukemia (AML) remains challenging. In patients with refractory or relapsed (R\/R) AML, the prognosis is still poor and this group is targeted for new drug development. We reviewed the outcome of 47 patients, with R\/R AML after at least one course of intensive chemotherapy, treated with 5\u2010azacytidine in three different French institutions. The overall response rate was 38% including complete remission in 21%, partial remission in 11%, and hematological improvement in 6% of cases. Median time to relapse was 6 (range, 1\u201339) months. Median overall survival was 9 months (not reached by responders vs. 4.5 months for nonresponders patients, <jats:italic>P<\/jats:italic> = 0.0001). Univariate analysis identified the absence of peripheral blood blasts and &lt;20% bone marrow blasts as prognostic factors for both overall response and survival, but not age, ECOG\/PS, type of AML, cytogenetic, status of the disease, number of previous lines of therapy, previous hematological stem cell transplantation, or white blood cells count. Bone marrow blasts percentage &lt;20% was the only independent prognostic factor identified by multivariate analysis for overall response (<jats:italic>P<\/jats:italic> = 0.0013) and survival (<jats:italic>P<\/jats:italic> = 0.0324). Six patients in remission could proceed to an allogenic hematological stem cell transplantation. The drug\u2010related grade 3\/4 adverse events were hematopoietic toxicities (38%) and infection (32%). In conclusion, this study suggests that a salvage therapy with 5\u2010azacytidine is an interesting option for patients with R\/R AML after intensive chemotherapy. Prospective randomized studies are needed to demonstrate a superiority of this approach over others strategies. Am. J. Hematol. 88:601\u2013605, 2013. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.23464","type":"journal-article","created":{"date-parts":[[2013,4,26]],"date-time":"2013-04-26T08:10:54Z","timestamp":1366963854000},"page":"601-605","source":"Crossref","is-referenced-by-count":47,"title":["5\u2010Azacytidine treatment for relapsed or refractory acute myeloid leukemia after intensive chemotherapy"],"prefix":"10.1002","volume":"88","author":[{"given":"Sarah","family":"Ivanoff","sequence":"first","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berengere","family":"Gruson","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvain P.","family":"Chantepie","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Caen  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilie","family":"Lemasle","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, Centre Henri Becquerel Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavinia","family":"Merlusca","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronique","family":"Harrivel","sequence":"additional","affiliation":[{"name":"Laboratoire d'H\u00e9matologie, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amandine","family":"Charbonnier","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Votte","sequence":"additional","affiliation":[{"name":"Pharmacie hospitali\u00e8re, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Royer","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Pierre","family":"Marolleau","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9matologie Clinique, CHU Amiens  France"},{"name":"EA4666 Universit\u00e9 Picardie Jules Verne Amiens France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,5,30]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/1042819021000006529"},{"key":"e_1_2_6_3_1","first-page":"1345","article-title":"Duration of second complete remission compared with first complete remission in patients with acute myeloid leukemia","volume":"14","author":"Lee S","year":"2000","journal-title":"Eastern Cooperative Oncology Group. 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