{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T18:52:36Z","timestamp":1789498356101,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T00:00:00Z","timestamp":1523491200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007313","name":"University of Texas MD Anderson Cancer Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007313","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004324","name":"Astellas Pharma US","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004324","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011096","name":"Jazz Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011096","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2018,6,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The prognosis is poor for patients who have relapsed\u2010refractory acute myelogenous leukemia (AML). Most published reports analyzed results from therapies in first\u2010salvage AML or in studies that were conducted before 2000. Several novel agents and strategies are being tested for potential approval as treatment for patients with relapsed\u2010refractory AML in second salvage. Therefore, it is important to establish the historic results of anti\u2010AML therapies in this setting in the modern era. The objective of the current study was to analyze the results from second salvage therapies in patients with AML since 2000 with regard to response and survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In total, 673 patients who received second salvage therapies for AML since 2000 were analyzed. Their median age was 60 years (range, 18\u201089 years). Salvage therapy consisted of cytarabine\u2010based regimens in 267 patients, noncytarabine combinations in 37, hypomethylating agent\u2010based regimens in 136, and phase 1 and 2 single agents in 233.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Eighty\u2010six of the 673 patients (13%) achieved a complete response (CR) or a CR with low platelet count (CRp). The median duration of CR\u2010CRp was 7.2 months. The median survival was 4.4 months (95% confidence interval, 4.0\u20104.8 months), and the 1\u2010year survival rate was 16% (95% confidence interval, 14%\u201019%). Multivariate analysis identified the following as independent adverse factors for achievement of CR\u2010CRp: platelets\u2009&lt;\u200950\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), complex karyotype with \u22653 chromosomal abnormalities (<jats:italic>P<\/jats:italic>\u2009=\u2009.02), regimens that did not include cytarabine or hypomethylating agents (<jats:italic>P<\/jats:italic>\u2009=\u2009.014), and no prior CR lasting \u226512 months with frontline or salvage 1 therapies (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The independent adverse factors associated with worse survival were age \u226560 years (<jats:italic>P<\/jats:italic>\u2009=\u2009.01), platelets\u2009&lt;\u200950\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (<jats:italic>P<\/jats:italic>\u2009=\u2009.02), peripheral blasts\u2009\u2265\u200920% (<jats:italic>P<\/jats:italic>\u2009=\u2009.03), albumin\u2009\u2264\u20093\u2009g\/dL (<jats:italic>P<\/jats:italic>\u2009=\u2009.04), and complex karyotype (<jats:italic>P<\/jats:italic>\u2009=\u2009.003). The authors also applied and validated, in the current population, the 2 multivariate\u2010derived prognostic models for CR and survival developed in their previous study of 594 patients who received treatment for second salvage AML from the previous 2 decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>This large\u2010scale analysis establishes the modern historic results of second salvage therapy in AML and validates the prognostic models associated with outcome. These data could be used to analyze the differential benefits of current or future investigational strategies under evaluation in this setting and for the purpose of potential approval of new agents in the United States and the world. <jats:bold><jats:italic>Cancer<\/jats:italic> 2018;124:2534\u201040.<\/jats:bold> \u00a9 <jats:italic>2018 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.31370","type":"journal-article","created":{"date-parts":[[2018,4,12]],"date-time":"2018-04-12T07:15:33Z","timestamp":1523517333000},"page":"2534-2540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Results of second salvage therapy in 673 adults with acute myelogenous leukemia treated at a single institution since 2000"],"prefix":"10.1002","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1908-3307","authenticated-orcid":false,"given":"Hagop M.","family":"Kantarjian","sequence":"first","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9003-0390","authenticated-orcid":false,"given":"Courtney D.","family":"DiNardo","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela M.","family":"Nogueras\u2010Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9892-9832","authenticated-orcid":false,"given":"Tapan M.","family":"Kadia","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4465-6119","authenticated-orcid":false,"given":"Elias","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos E.","family":"Bueso\u2010Ramos","sequence":"additional","affiliation":[{"name":"Department of Hematopathology The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3386-6540","authenticated-orcid":false,"given":"Susan M.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Chao Family Comprehensive Cancer Center University of California at Irvine Irvine 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Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Champlin","sequence":"additional","affiliation":[{"name":"Department of Cellular Therapy and Stem Cell Transplantation The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Simkins","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Texas Health Science Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Garcia\u2010Manero","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Keating","sequence":"additional","affiliation":[{"name":"Department of Leukemia The University of Texas MD Anderson Cancer Center 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