{"id":16392,"date":"2022-12-08T15:28:32","date_gmt":"2022-12-08T14:28:32","guid":{"rendered":"https:\/\/convergences.online\/hemato\/?p=16392"},"modified":"2024-12-11T18:29:39","modified_gmt":"2024-12-11T17:29:39","slug":"azacitidine-orale-en-cas-de-mutation-npm1-et-ou-flt-3","status":"publish","type":"post","link":"https:\/\/www.hematostat.net\/en\/azacitidine-orale-en-cas-de-mutation-npm1-et-ou-flt-3\/","title":{"rendered":"Azacitidine orale en cas de mutation NPM1 et\/ou FLT-3"},"content":{"rendered":"

R\u00e9f. : HematoStat.net ; 3 (4) : R65<\/p>\n

Prognostic impact of NPM1 and FLT3 mutations in patients with AML in first remission treated with oral azacitidine. D\u00f6hner H, Wei AH, Roboz GJ, Montesinos P, Thol FR, Ravandi F, et al. <\/span>Blood. 13 oct 2022;140(15):1674\u201185.<\/a><\/i><\/p>\n

R\u00e9sum\u00e9 de l’article<\/h3>\n

Dans l\u2019essai QUAZAR AML-001, les patients en r\u00e9mission apr\u00e8s chimioth\u00e9rapie intensive (CI) non-candidats \u00e0 une allogreffe recevaient une maintenance par azacitidine (aza) orale ou un placebo. Les patients trait\u00e9s par aza orale et avec mutation NPM1 (NPM1m) avaient une survie globale (SG) de 47,2 mois contre 19,6 mois pour les patients non mut\u00e9s. En analyse multivari\u00e9e, l\u2019aza orale am\u00e9liorait la SG ind\u00e9pendamment du statut NPM1, FLT-3, du risque cytog\u00e9n\u00e9tique ou de la maladie r\u00e9siduelle apr\u00e8s CI.<\/p>\n

Dans nos pratiques<\/h3>\n

L\u2019aza orale a eu l\u2019AMM en 2021 pour les patients en r\u00e9mission apr\u00e8s CI ne pouvant ou ne souhaitant pas b\u00e9n\u00e9ficier d\u2019une allogreffe. Cette analyse post-hoc souligne le b\u00e9n\u00e9fice chez les patients NPM1m y compris pour ceux pr\u00e9sentant une maladie r\u00e9siduelle n\u00e9gative (immunoph\u00e9notypage, seuil de 0,1 %). Toutefois, il convient de temp\u00e9rer ces r\u00e9sultats en rappelant que 20 % des patients inclus dans l\u2019essai n\u2019ont pas re\u00e7u de traitement de consolidation.<\/p>\n

Regard du statisticien<\/h3>\n

L\u2019analyse de mutations s\u2019est faite \u00e0 partir d\u2019une \u00e9tude randomis\u00e9e. Les r\u00e9sultats sont int\u00e9ressants, cependant il aurait \u00e9t\u00e9 plus prudent d\u2019effectuer des corrections de p-values<\/i> entre les diff\u00e9rentes combinaisons traitement-mutation pour les courbes de survie \u00e9tant donn\u00e9 que nous sommes logiquement dans le cadre de tests multiples. Une autre suggestion : des forest-plots<\/i> pour synth\u00e9tiser l\u2019ensemble des r\u00e9sultats auraient \u00e9t\u00e9 appr\u00e9ciables. <\/span><\/p>\n<\/div><\/div><\/div><\/div><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":16,"featured_media":16393,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[36],"tags":[67,358,359],"ppma_author":[456],"class_list":["post-16392","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revue-de-presse","tag-azacitidine","tag-forest-plots","tag-npm1m","author-alexis-genthon"],"aioseo_notices":[],"authors":[{"term_id":456,"user_id":16,"is_guest":0,"slug":"alexis-genthon","display_name":"Alexis GENTHON","avatar_url":{"url":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png","url2x":"https:\/\/www.hematostat.net\/wp-content\/uploads\/2023\/06\/Capture-decran-2021-05-07-a-14.25.02.png"},"first_name":"","last_name":"","user_url":"","description":"H\u00e9matologue.\r\nCorrespondance : H\u00f4pital Saint-Antoine \r\nService h\u00e9matologie clinique\r\n184 rue du Faubourg Saint-Antoine 75012 Paris."}],"_links":{"self":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16392","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/users\/16"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/comments?post=16392"}],"version-history":[{"count":1,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16392\/revisions"}],"predecessor-version":[{"id":18237,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/posts\/16392\/revisions\/18237"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/media?parent=16392"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/categories?post=16392"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/tags?post=16392"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.hematostat.net\/en\/wp-json\/wp\/v2\/ppma_author?post=16392"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}