{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T04:23:10Z","timestamp":1793938990512,"version":"4.8.0"},"reference-count":22,"publisher":"American Society of Hematology","issue":"20","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,11,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Addition of gemtuzumab ozogamicin (GO) to induction chemotherapy improves outcomes in older patients with acute myeloid leukemia (AML), but it is uncertain whether a fractionated schedule provides additional benefit to a single dose. We randomized 852 older adults (median age, 68-years) with AML\/high-risk myelodysplasia to GO on day\u00a01 (GO1) or on days\u00a01 and 4 (GO2) of course\u00a01 induction. The median follow-up period was 50.2 months. Although complete remission (CR) rates after course 1 did not significantly differ between arms (GO2, 63%; GO1, 57%; odds ratio [OR], 0.78; P = .08), there were significantly more patients who achieved CR with a measurable residual disease (MRD)&amp;lt;0.1% (50% vs 41%; OR, 0.72; P = .027). This differential MRD reduction with GO2 varied across molecular subtypes, being greatest for IDH mutations. The 5-year overall survival (OS) was 29% for\u00a0patients in the GO2 arm and 24% for those in the GO1 arm (hazard ratio [HR], 0.89; P = .14). In a sensitivity analysis excluding patients found to have adverse cytogenetics or TP53 mutations, the 5-year OS was 33% for GO2 and 26% for GO1 (HR,\u00a00.83; P = .045). In total, 228 (27%) patients received an allogeneic transplantation in first remission. Posttransplant OS was superior in the GO2 arm (HR, 0.67; P = .033); furthermore, the survival advantage from GO2 in the sensitivity analysis was lost when data of patients were censored at transplantation. In conclusion, GO2 was associated with a greater reduction in MRD and improved survival in older adults with nonadverse risk genetics. This benefit from GO2 was dependent on allogeneic transplantation to translate the better leukemia clearance into improved survival. This trial was registered at www.isrctn.com as #ISRCTN\u00a031682779.<\/jats:p>","DOI":"10.1182\/blood.2023020630","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T17:54:45Z","timestamp":1692381285000},"page":"1697-1707","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":46,"title":["Fractionated vs single-dose gemtuzumab ozogamicin with determinants of benefit in older patients with AML: the UK NCRI AML18 trial"],"prefix":"10.1182","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1869-180X","authenticated-orcid":false,"given":"Sylvie D.","family":"Freeman","sequence":"first","affiliation":[{"name":"1Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8283-6762","authenticated-orcid":false,"given":"Abin","family":"Thomas","sequence":"additional","affiliation":[{"name":"2Centre for Trials Research, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Thomas","sequence":"additional","affiliation":[{"name":"2Centre for Trials Research, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K.","family":"Hills","sequence":"additional","affiliation":[{"name":"3Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3931-0914","authenticated-orcid":false,"given":"Paresh","family":"Vyas","sequence":"additional","affiliation":[{"name":"4Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Gilkes","sequence":"additional","affiliation":[{"name":"5Cardiff University School of Medicine, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1806-0952","authenticated-orcid":false,"given":"Marlen","family":"Metzner","sequence":"additional","affiliation":[{"name":"4Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5776-5085","authenticated-orcid":false,"given":"Niels Asger","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"4Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6681-3256","authenticated-orcid":false,"given":"Alison","family":"Kennedy","sequence":"additional","affiliation":[{"name":"6Wellcome, Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9595-7786","authenticated-orcid":false,"given":"Rachel","family":"Moore","sequence":"additional","affiliation":[{"name":"4Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria Marquez","family":"Almuina","sequence":"additional","affiliation":[{"name":"2Centre for Trials Research, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Burns","sequence":"additional","affiliation":[{"name":"2Centre for Trials Research, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"King","sequence":"additional","affiliation":[{"name":"2Centre for Trials Research, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Andrew","sequence":"additional","affiliation":[{"name":"7Laboratory of Myeloid Malignancies, National Heart, Lung, and Blood Institute, Bethesda, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M. 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