TY - JOUR
T1 - Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old
T2 - a retrospective analysis from the PETHEMA registry
AU - Martínez-Cuadrón, David
AU - Megías-Vericat, Juan E.
AU - Gil, Cristina
AU - Bernal, Teresa
AU - Tormo, Mar
AU - Martínez-Sánchez, Pilar
AU - Rodríguez-Medina, Carlos
AU - Serrano, Josefina
AU - Herrera, Pilar
AU - Pérez Simón, José A.
AU - Sayas, María J.
AU - Bergua, Juan
AU - Lavilla-Rubira, Esperanza
AU - Amigo, María Luz
AU - Benavente, Celina
AU - López Lorenzo, Jose L.
AU - Pérez-Encinas, Manuel M.
AU - Vidriales, María B.
AU - Colorado, Mercedes
AU - de Rueda, Beatriz
AU - García-Boyero, Raimundo
AU - Marini, Sandra
AU - García-Suárez, Julio
AU - López-Pavía, María
AU - Gómez-Roncero, Maria I.
AU - Noriega, Víctor
AU - López, Aurelio
AU - Labrador, Jorge
AU - Cabello, Ana
AU - Sossa, Claudia
AU - Algarra, Lorenzo
AU - Stevenazzi, Mariana
AU - Solana-Altabella, Antonio
AU - Boluda, Blanca
AU - Montesinos, Pau
N1 - Publisher Copyright:
©2024 Ferrata Storti Foundation.
PY - 2024/1
Y1 - 2024/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85181852670&partnerID=8YFLogxK
U2 - 10.3324/haematol.2022.282506
DO - 10.3324/haematol.2022.282506
M3 - Artículo Científico
C2 - 37199127
AN - SCOPUS:85181852670
SN - 0390-6078
VL - 109
SP - 115
EP - 128
JO - Haematologica
JF - Haematologica
IS - 1
ER -