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

• Published in: Haematologica (Roma)
• Main Authors: Martínez-Cuadrón, David, Megías-Vericat, Juan E., Gil, Cristina, Bernal, Teresa, Tormo, Mar, Martínez-Sánchez, Pilar, Rodríguez-Medina, Carlos, Serrano, Josefina, Herrera, Pilar, Simón, José A. Pérez, Sayas, María J., Bergua, Juan, Lavilla-Rubira, Esperanza, Amigo, Maria Luz, Benavente, Celina, Lorenzo, Jose L. López, Pérez-Encinas, Manuel M., Vidriales, María B., Colorado, Mercedes, De Rueda, Beatriz, García-Boyero, Raimundo, Marini, Sandra, García-Suárez, Julio, López-Pavía, María, Gómez-Roncero, Maria I., Noriega, Víctor, López, Aurelio, Labrador, Jorge, Cabello, Ana, Sossa, Claudia, Algarra, Lorenzo, Stevenazzi, Mariana, Solana-Altabella, Antonio, Boluda, Blanca, Montesinos, Pau
• Format: Journal Article
• Language: English
• Published: 18.05.2023
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.2022.282506

Treatment options for patients with secondary and myeloid related changes acute myeloid leukemia (sAML and AML-MRC) aged 60-75 years old 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. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60-75 years treated with intensive chemotherapy (IC), reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS 7.6 months (CI95%, 6.7-8.5) and event-free survival (EFS) 2.7 months (CI95%, 2-3.3), without differences between IC regimens and AML type. Multivariate analyses identified age ≥70 years, ECOG≥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), auto-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.