Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry

David Martínez-Cuadrón, Juan E. Megías-Vericat, Cristina Gil, Teresa Bernal, Mar Tormo, Pilar Martínez-Sánchez, Carlos Rodríguez-Medina, Josefina Serrano, Pilar Herrera, José A. Pérez Simón, María J. Sayas, Juan Bergua, Esperanza Lavilla-Rubira, María Luz Amigo, Celina Benavente, Jose L. López Lorenzo, Manuel M. Pérez-Encinas, María B. Vidriales, Mercedes Colorado, Beatriz de RuedaRaimundo García-Boyero, Sandra Marini, Julio García-Suárez, María López-Pavía, Maria I. Gómez-Roncero, Víctor Noriega, Aurelio López, Jorge Labrador, Ana Cabello, Claudia Sossa, Lorenzo Algarra, Mariana Stevenazzi, Antonio Solana-Altabella, Blanca Boluda, Pau Montesinos

Research output: Articles / NotesScientific Articlepeer-review

1 Scopus citations

Abstract

Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AML-MRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.

Original languageEnglish
Pages (from-to)115-128
Number of pages14
JournalHaematologica
Volume109
Issue number1
DOIs
StatePublished - Jan 2024

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