Acute myeloid leukaemia blast cells with a tyrosine kinase domain mutation of FLT3 are less sensitive to lestaurtinib than those with a FLT3 internal tandem duplication.

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Clinical Guidelines
Authored By
Mead, Adam J., Gale, Rosemary E., Kottaridis, Panagiotis D., Matsuda, Satomi, Khwaja, Asim, Linch, David C.
Authored On
Interests
Obstetrics & Gynecology
Speciality
Obstetrics & Gynecology
Book Detail
volume
141
ISSN
00071048
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{"article_title":"[Breech Presentation: CNGOF Guidelines for Clinical Practice - External Cephalic Version and other Interventions to turn Breech Babies to Cephalic Presentation].","author":"Ducarme G","journal_title":"Gynecologie, obstetrique, fertilite & senologie","issn":"2468-7189","isbn":"","publication_date":"2020-01-01","volume":"48","issue":"1","first_page":"81","page_count":"","accession_number":"31678503","doi":"10.1016\/j.gofs.2019.10.024","publisher":"Elsevier Masson SAS","doctype":"Journal Article","subjects":"France; Breech Presentation therapy; Version, Fetal methods; Cesarean Section statistics & numerical data; Delivery, Obstetric methods; Female; France; Gestational Age; Gynecology methods; Humans; MEDLINE; Meta-Analysis as Topic; Obstetrics methods; Pregnancy; Risk Assessment","interest_area":["Obstetrics & Gynecology"],"abstract":"Objectives: To provide guidelines regarding efficiency and safety of external cephalic version (ECV) attempt and alternatives methods to turn breech babies to cephalic presentation. Methods: MedLine and Cochrane Library databases search in French and English and review of the main foreign guidelines between 1980 and 2019. Results: ECV is associated with a decreasing rate of breech presentation at birth (LE2), and potentially with a lower rate of cesarean section (LE3) without an increase of severe maternal (LE3) and perinatal morbidity (LE3). It is therefore recommended to inform women with a breech presentation at term that ECV should be attempt (Professional consensus). ECV attempt should be performed with immediate access to an operating room for emergency cesarean (Professional consensus). The ECV attempt before 37 weeks, compared to ECV attempt after 37 weeks, increases the rate of cephalic presentation at birth (LE2) but with a small increase risk of moderate prematurity (LE2). ECV attempt should be performed from 36SA (Professional consensus). The main factors associated with successful ECV attempt are multiparity (LE3) and no maternal obesity (LE3). Parenteral tocolysis (\u03b2 mimetic or atosiban), for ECV attempt at term is associated with a higher success rate (LE2), higher rate of achieved cephalic presentation in labor (LE2) and a lower cesarean section rate (LE2). It is recommended to use parenteral tocolysis for ECV attempt at term in order to increase its success rate (grade B). The ECV attempt is associated with an increase in transient FHR abnormalities (LE3), it is therefore recommended that cardiotocography should be performed prior and during 30minutes after the procedure (Professional consensus). There is no argument for recommending the practice of delayed cardiotocography after ECV attempt (Professional consensus). The risk of significant positivity (>30mL) of the Kleihauer test after ECV attempt is low (<0.1%) (LE3), it is not recommended to systematically perform a Kleihauer test after ECV attempt (professional consensus). In case of RH-1 negative women, it is recommended to ensure systematic RH-1 prophylaxis (Professional consensus). In case of breech presentation at term, acupuncture, moxibustion and postural methods are not effective in reducing breech presentation at birth (LE2), and are therefore not recommended (Grade B). Conclusion: According to the clear benefits and the low risks of ECV attempt, all women with a breech presentation at term should be informed that ECV should be attempted to decrease breech presentation at birth and cesarean section. Copyright \u00a9 2019 Elsevier Masson SAS. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=31678503","isPdfLink":true,"isSAML":false,"an":"31678503","number_other":"","type_pub":"","issn_electronic":"2468-7189","languages":"French","language":"fre","date_entry":"Date Created: 20191104 Date Completed: 20201113 Latest Revision: 20201113","date_update":"20240104","titleSource":"Gynecologie, obstetrique, fertilite & senologie [Gynecol Obstet Fertil Senol] 2020 Jan; Vol. 48 (1), pp. 81-94. Date of Electronic Publication: 2019 Oct 31.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2020-01-01","description":"Objectives: To provide guidelines regarding efficiency and safety of external cephalic version (ECV) attempt and alternatives methods to turn breech babies to cephalic presentation.&lt;br \/&gt;Methods: MedLine and Cochrane Library databases search in French and English and review of the main foreign guidelines between 1980 and 2019.&lt;br \/&gt;Results: ECV is associated with a decreasing rate of breech presentation at birth (LE2), and potentially with a lower rate of cesarean section (LE3) without an increase of severe maternal (LE3) and perinatal morbidity (LE3). It is therefore recommended to inform women with a breech presentation at term that ECV should be attempt (Professional consensus). ECV attempt should be performed with immediate access to an operating room for emergency cesarean (Professional consensus). The ECV attempt before 37&#160;weeks, compared to ECV attempt after 37&#160;weeks, increases the rate of cephalic presentation at birth (LE2) but with a small increase risk of moderate prematurity (LE2). ECV attempt should be performed from 36SA (Professional consensus). The main factors associated with successful ECV attempt are multiparity (LE3) and no maternal obesity (LE3). Parenteral tocolysis (\u03b2 mimetic or atosiban), for ECV attempt at term is associated with a higher success rate (LE2), higher rate of achieved cephalic presentation in labor (LE2) and a lower cesarean section rate (LE2). It is recommended to use parenteral tocolysis for ECV attempt at term in order to increase its success rate (grade B). The ECV attempt is associated with an increase in transient FHR abnormalities (LE3), it is therefore recommended that cardiotocography should be performed prior and during 30minutes after the procedure (Professional consensus). There is no argument for recommending the practice of delayed cardiotocography after ECV attempt (Professional consensus). The risk of significant positivity (&gt;30mL) of the Kleihauer test after ECV attempt is low (&lt;0.1%) (LE3), it is not recommended to systematically perform a Kleihauer test after ECV attempt (professional consensus). In case of RH-1 negative women, it is recommended to ensure systematic RH-1 prophylaxis (Professional consensus). In case of breech presentation at term, acupuncture, moxibustion and postural methods are not effective in reducing breech presentation at birth (LE2), and are therefore not recommended (Grade B).&lt;br \/&gt;Conclusion: According to the clear benefits and the low risks of ECV attempt, all women with a breech presentation at term should be informed that ECV should be attempted to decrease breech presentation at birth and cesarean section.&lt;br \/&gt; (Copyright &#169; 2019 Elsevier Masson SAS. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=edb&AN=31678503&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"Ducarme G","additionalInfo":{"Authored_By":"Mead, Adam J., Gale, Rosemary E., Kottaridis, Panagiotis D., Matsuda, Satomi, Khwaja, Asim, Linch, David C.","Published_Date":"2008-05-15","Source":"British Journal of Haematology; May2008, Vol. 141 Issue 4, p454-460, 7p, 1 Chart, 3 Graphs","Languages":"English","Subjects":"MYELOID leukemia, NONLYMPHOID leukemia, ACUTE myeloid leukemia, PROTEIN-tyrosine kinases, PATIENTS","Title_Abbreviations":"British Journal of Haematology","Volume":"141"},"header":{"DbId":"edb","DbLabel":"Complementary Index","An":"31678503","RelevancyScore":"833","PubType":"Academic Journal","PubTypeId":"academicJournal","PreciseRelevancyScore":"833.195617675781"},"plink":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&db=edb&AN=31678503&authtype=shib&custid=ns346513&group=main&profile=eds"}
ISSN
2468-7189
IS_Ebsco
true
Additional Info
["Mead, Adam J., Gale, Rosemary E., Kottaridis, Panagiotis D., Matsuda, Satomi, Khwaja, Asim, Linch, David C.","2008-05-15","British Journal of Haematology; May2008, Vol. 141 Issue 4, p454-460, 7p, 1 Chart, 3 Graphs","English","MYELOID leukemia, NONLYMPHOID leukemia, ACUTE myeloid leukemia, PROTEIN-tyrosine kinases, PATIENTS","British Journal of Haematology","141"]
Description
FLT3 tyrosine kinase domain mutations (FLT3/TKDs) are associated with a favourable prognosis in acute myeloid leukaemia (AML), unlike FLT3 internal tandem duplications (FLT3/ITDs) that have a poor prognosis. Whilst FLT3/ITD<superscript>+</superscript> cells are more susceptible to the cytotoxic effects of FLT3 inhibitors than wild type (WT) cells, the sensitivity of FLT3/TKD<superscript>+</superscript> cells to therapeutic agents is unclear, as is the importance of the mutant level. We therefore studied the effect of cytarabine and the FLT3 inhibitor lestaurtinib, either alone or in combination, on in vitro survival of blast cells from 36 cases of AML (14 FLT3/WT, 11 FLT3/ITD<superscript>+</superscript> and 11 FLT3/TKD<superscript>+</superscript>). All three groups showed similar sensitivity to the cytotoxic effects of cytarabine but FLT3/ITD mutant level was inversely correlated with cytarabine cytotoxicity ( P = 0·04) whereas FLT3/TKD mutant level had no impact. FLT3/TKD<superscript>+</superscript> cells showed a similar response to lestaurtinib as FLT3/WT cells, whereas FLT3/ITD<superscript>+</superscript> cells were more sensitive ( P = 0·004). There was no correlation between mutant level and lestaurtinib sensitivity for either FLT3/ITD<superscript>+</superscript> or FLT3/TKD<superscript>+</superscript> cells. Synergistic cytotoxicity of lestaurtinib plus cytarabine was demonstrated in all three groups. These results suggest that FLT3/TKD<superscript>+</superscript> and FLT3/WT cases should not be differentiated when considering patients for treatment with FLT3 inhibitors. [ABSTRACT FROM AUTHOR]
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