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Pediatric AML: Minimally myelosuppressive remission induction regimen comparable to standard chemotherapy
Key clinical point: Long-term survival in children with acute myeloid leukemia (AML) who receive low-dose chemotherapy (LDC) for remission induction is comparable to that of children who receive standard-dose chemotherapy (SDC).
Major finding: No significant differences were observed between the LDC and SDC groups in 5-year event-free survival (61.4% ± 8.7% vs 65.2% ± 7.4%, respectively; P = .462), overall survival (72.7% ± 6.9% vs 72.5% ± 6.2%, respectively; P = .933), and the incidence of relapse (20.5% ± 4.5% vs 17.6% ± 3.9%, respectively; P = .484).
Study details: Long-term follow-up of 83 patients with AML treated with a LDC regimen (and 100 children with AML treated with a standard-dose chemotherapy (SDC) regimen.
Disclosures: This work was supported by NSCF, the Key Research Program of the Chinese Academy of Sciences, the Jiangsu Province Foundation, the National Clinical Research Center for Hematological Disorders, and the Youth Innovation Promotion Association of Chinese Academy of Sciences. The authors declared no conflicts of interest.
Source: Hu Y et al. Blood Adv. 2021 Apr 13. doi: 10.1182/bloodadvances.2020003453.
Key clinical point: Long-term survival in children with acute myeloid leukemia (AML) who receive low-dose chemotherapy (LDC) for remission induction is comparable to that of children who receive standard-dose chemotherapy (SDC).
Major finding: No significant differences were observed between the LDC and SDC groups in 5-year event-free survival (61.4% ± 8.7% vs 65.2% ± 7.4%, respectively; P = .462), overall survival (72.7% ± 6.9% vs 72.5% ± 6.2%, respectively; P = .933), and the incidence of relapse (20.5% ± 4.5% vs 17.6% ± 3.9%, respectively; P = .484).
Study details: Long-term follow-up of 83 patients with AML treated with a LDC regimen (and 100 children with AML treated with a standard-dose chemotherapy (SDC) regimen.
Disclosures: This work was supported by NSCF, the Key Research Program of the Chinese Academy of Sciences, the Jiangsu Province Foundation, the National Clinical Research Center for Hematological Disorders, and the Youth Innovation Promotion Association of Chinese Academy of Sciences. The authors declared no conflicts of interest.
Source: Hu Y et al. Blood Adv. 2021 Apr 13. doi: 10.1182/bloodadvances.2020003453.
Key clinical point: Long-term survival in children with acute myeloid leukemia (AML) who receive low-dose chemotherapy (LDC) for remission induction is comparable to that of children who receive standard-dose chemotherapy (SDC).
Major finding: No significant differences were observed between the LDC and SDC groups in 5-year event-free survival (61.4% ± 8.7% vs 65.2% ± 7.4%, respectively; P = .462), overall survival (72.7% ± 6.9% vs 72.5% ± 6.2%, respectively; P = .933), and the incidence of relapse (20.5% ± 4.5% vs 17.6% ± 3.9%, respectively; P = .484).
Study details: Long-term follow-up of 83 patients with AML treated with a LDC regimen (and 100 children with AML treated with a standard-dose chemotherapy (SDC) regimen.
Disclosures: This work was supported by NSCF, the Key Research Program of the Chinese Academy of Sciences, the Jiangsu Province Foundation, the National Clinical Research Center for Hematological Disorders, and the Youth Innovation Promotion Association of Chinese Academy of Sciences. The authors declared no conflicts of interest.
Source: Hu Y et al. Blood Adv. 2021 Apr 13. doi: 10.1182/bloodadvances.2020003453.
ASXL1-mutated ALL patients can benefit from allo-HSCT
Key clinical point: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may improve survival outcomes in acute myeloid leukemia (AML) patients with ASXL1 mutations.
Major finding: In multivariate analysis, ASXL1 mutation was found to be an independent prognostic factor for overall survival (OS; hazard ratio [HR], 2.248; P = .017). Furthermore, Allo-HSCT was associated with significant improvements in overall survival (HR 7.568; P less than .001) and disease-free survival (HR, 2.611; P less than .001) in ASXL1-mutated ALL patients.
Study details: Analysis of the prognostic value of ASXL1 mutations and the role of allo-HSCT in 581 patients with AML.
Disclosures: The study was supported by grants from the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, the Social Development Project of Jiangsu Province, the Priority Academic Program Development of Jiangsu Higher Education Institutions, and the National Key Research and Development Program. The authors declared no conflicts of interest.
Source: Zhou L et al. Hematology. 2021 Apr 10. doi: 10.1080/16078454.2021.1905356.
Key clinical point: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may improve survival outcomes in acute myeloid leukemia (AML) patients with ASXL1 mutations.
Major finding: In multivariate analysis, ASXL1 mutation was found to be an independent prognostic factor for overall survival (OS; hazard ratio [HR], 2.248; P = .017). Furthermore, Allo-HSCT was associated with significant improvements in overall survival (HR 7.568; P less than .001) and disease-free survival (HR, 2.611; P less than .001) in ASXL1-mutated ALL patients.
Study details: Analysis of the prognostic value of ASXL1 mutations and the role of allo-HSCT in 581 patients with AML.
Disclosures: The study was supported by grants from the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, the Social Development Project of Jiangsu Province, the Priority Academic Program Development of Jiangsu Higher Education Institutions, and the National Key Research and Development Program. The authors declared no conflicts of interest.
Source: Zhou L et al. Hematology. 2021 Apr 10. doi: 10.1080/16078454.2021.1905356.
Key clinical point: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) may improve survival outcomes in acute myeloid leukemia (AML) patients with ASXL1 mutations.
Major finding: In multivariate analysis, ASXL1 mutation was found to be an independent prognostic factor for overall survival (OS; hazard ratio [HR], 2.248; P = .017). Furthermore, Allo-HSCT was associated with significant improvements in overall survival (HR 7.568; P less than .001) and disease-free survival (HR, 2.611; P less than .001) in ASXL1-mutated ALL patients.
Study details: Analysis of the prognostic value of ASXL1 mutations and the role of allo-HSCT in 581 patients with AML.
Disclosures: The study was supported by grants from the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, the Social Development Project of Jiangsu Province, the Priority Academic Program Development of Jiangsu Higher Education Institutions, and the National Key Research and Development Program. The authors declared no conflicts of interest.
Source: Zhou L et al. Hematology. 2021 Apr 10. doi: 10.1080/16078454.2021.1905356.
AML: Consolidation treatment with intermediate-dose cytarabine is acceptable
Key clinical point: No significant difference was seen in the 1-year relapse-free survival (RFS) relapse-free survival rate (RFS) and overall survival (OS) between intermediate-dose cytarabine (IDAC) and high-dose cytarabine (HiDAC) in patients with acute myeloid leukemia (AML).
Major finding: One-year RFS was 63.33% in the IDAC group vs. 46.87% in the HiDAC group (P = .137). One-year OS was 93.33% in the IDAC group vs. 84.37% in the HiDAC group (P = .691). IDAC group vs HiDAC group had significantly shorter duration of grade 3–4 thrombocytopenia (mean duration, 14.69 vs. 23.84 days; P = .045).
Study details: The data come from a retrospective study involvoing 62 patients with AML (30 patients in IDAC and 32 patients in HiDAC regimen).
Disclosures: The authors declared no conflicts of interest.
Source: Tangchitpianvit K et al. Hematology. 2021 Apr 14. doi: 10.1080/16078454.2021.1912949.
Key clinical point: No significant difference was seen in the 1-year relapse-free survival (RFS) relapse-free survival rate (RFS) and overall survival (OS) between intermediate-dose cytarabine (IDAC) and high-dose cytarabine (HiDAC) in patients with acute myeloid leukemia (AML).
Major finding: One-year RFS was 63.33% in the IDAC group vs. 46.87% in the HiDAC group (P = .137). One-year OS was 93.33% in the IDAC group vs. 84.37% in the HiDAC group (P = .691). IDAC group vs HiDAC group had significantly shorter duration of grade 3–4 thrombocytopenia (mean duration, 14.69 vs. 23.84 days; P = .045).
Study details: The data come from a retrospective study involvoing 62 patients with AML (30 patients in IDAC and 32 patients in HiDAC regimen).
Disclosures: The authors declared no conflicts of interest.
Source: Tangchitpianvit K et al. Hematology. 2021 Apr 14. doi: 10.1080/16078454.2021.1912949.
Key clinical point: No significant difference was seen in the 1-year relapse-free survival (RFS) relapse-free survival rate (RFS) and overall survival (OS) between intermediate-dose cytarabine (IDAC) and high-dose cytarabine (HiDAC) in patients with acute myeloid leukemia (AML).
Major finding: One-year RFS was 63.33% in the IDAC group vs. 46.87% in the HiDAC group (P = .137). One-year OS was 93.33% in the IDAC group vs. 84.37% in the HiDAC group (P = .691). IDAC group vs HiDAC group had significantly shorter duration of grade 3–4 thrombocytopenia (mean duration, 14.69 vs. 23.84 days; P = .045).
Study details: The data come from a retrospective study involvoing 62 patients with AML (30 patients in IDAC and 32 patients in HiDAC regimen).
Disclosures: The authors declared no conflicts of interest.
Source: Tangchitpianvit K et al. Hematology. 2021 Apr 14. doi: 10.1080/16078454.2021.1912949.
Acute kidney injury negatively affects clinical course of AML
Key clinical point: Presence of acute kidney injury (AKI) may have an adverse impact on the clinical course of patients with acute myeloid leukemia (AML) treated with induction chemotherapy.
Major finding: 72 (18%) AML patients had AKI during induction chemotherapy. AML patients with AKI vs without AKI had more days with fever (7 vs. 5, P = .028) and require treatment intensive care unit more often (45.8% vs. 10.6%, P less than .001). AML patients with AKI also had a significantly lower complete remission rate following induction chemotherapy and shorter median overall survival.
Study details: Retrospective analysis of data from 401 patients with AML undergoing induction chemotherapy between 2007 and 2019.
Disclosures: Open access funding was enabled and organized by Projekt DEAL. The authors declared no conflicts of interest.
Source: Ballo O et al. Ann Hematol. 2021 March 11. doi: 10.1007/s00277-021-04482-3.
Key clinical point: Presence of acute kidney injury (AKI) may have an adverse impact on the clinical course of patients with acute myeloid leukemia (AML) treated with induction chemotherapy.
Major finding: 72 (18%) AML patients had AKI during induction chemotherapy. AML patients with AKI vs without AKI had more days with fever (7 vs. 5, P = .028) and require treatment intensive care unit more often (45.8% vs. 10.6%, P less than .001). AML patients with AKI also had a significantly lower complete remission rate following induction chemotherapy and shorter median overall survival.
Study details: Retrospective analysis of data from 401 patients with AML undergoing induction chemotherapy between 2007 and 2019.
Disclosures: Open access funding was enabled and organized by Projekt DEAL. The authors declared no conflicts of interest.
Source: Ballo O et al. Ann Hematol. 2021 March 11. doi: 10.1007/s00277-021-04482-3.
Key clinical point: Presence of acute kidney injury (AKI) may have an adverse impact on the clinical course of patients with acute myeloid leukemia (AML) treated with induction chemotherapy.
Major finding: 72 (18%) AML patients had AKI during induction chemotherapy. AML patients with AKI vs without AKI had more days with fever (7 vs. 5, P = .028) and require treatment intensive care unit more often (45.8% vs. 10.6%, P less than .001). AML patients with AKI also had a significantly lower complete remission rate following induction chemotherapy and shorter median overall survival.
Study details: Retrospective analysis of data from 401 patients with AML undergoing induction chemotherapy between 2007 and 2019.
Disclosures: Open access funding was enabled and organized by Projekt DEAL. The authors declared no conflicts of interest.
Source: Ballo O et al. Ann Hematol. 2021 March 11. doi: 10.1007/s00277-021-04482-3.
FLT3 mutated AML: Posttransplant maintenance TKI treatment is safe and effective
Key clinical point: Maintenance treatment with tyrosine kinase inhibitors (TKIs) following Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is safe and effective in patients with FLT3 mutated acute myeloid leukemia (AML).
Major finding: After a median follow-up of 10 months after allo-HSCT, 29 patients (71%) were alive and in complete remission (CR). In the subgroup of pretransplant TKI-treated patients, 25 patients (78%) were alive and in CR. 17 patients (41%) experienced side effects and 7 patients (17%) discontinued TKIs as a result of adverse events.
Study details: The data come from a retrospective observational study involving 41 patients treated with posttransplant TKIs (sorafenib, n = 23; midostaurin, n = 18). 32 patients (79%) had also received TKIs before allo-HSCT.
Disclosures: The authors declared no conflicts of interest.
Source: Shimony S et al. Leuk Lymphoma. 2021 Apr 21. doi: 10.1080/10428194.2021.1913145.
Key clinical point: Maintenance treatment with tyrosine kinase inhibitors (TKIs) following Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is safe and effective in patients with FLT3 mutated acute myeloid leukemia (AML).
Major finding: After a median follow-up of 10 months after allo-HSCT, 29 patients (71%) were alive and in complete remission (CR). In the subgroup of pretransplant TKI-treated patients, 25 patients (78%) were alive and in CR. 17 patients (41%) experienced side effects and 7 patients (17%) discontinued TKIs as a result of adverse events.
Study details: The data come from a retrospective observational study involving 41 patients treated with posttransplant TKIs (sorafenib, n = 23; midostaurin, n = 18). 32 patients (79%) had also received TKIs before allo-HSCT.
Disclosures: The authors declared no conflicts of interest.
Source: Shimony S et al. Leuk Lymphoma. 2021 Apr 21. doi: 10.1080/10428194.2021.1913145.
Key clinical point: Maintenance treatment with tyrosine kinase inhibitors (TKIs) following Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is safe and effective in patients with FLT3 mutated acute myeloid leukemia (AML).
Major finding: After a median follow-up of 10 months after allo-HSCT, 29 patients (71%) were alive and in complete remission (CR). In the subgroup of pretransplant TKI-treated patients, 25 patients (78%) were alive and in CR. 17 patients (41%) experienced side effects and 7 patients (17%) discontinued TKIs as a result of adverse events.
Study details: The data come from a retrospective observational study involving 41 patients treated with posttransplant TKIs (sorafenib, n = 23; midostaurin, n = 18). 32 patients (79%) had also received TKIs before allo-HSCT.
Disclosures: The authors declared no conflicts of interest.
Source: Shimony S et al. Leuk Lymphoma. 2021 Apr 21. doi: 10.1080/10428194.2021.1913145.
Gemtuzumab ozogamycin heightens risk for toxicities with no survival benefit in de novo AML
Key clinical point: The addition of gemtuzumab ozogamycin (GO) to standard chemotherapy (SC) did not improve survival in younger patients with de novo acute myeloid leukemia (AML) and intermediate-risk (IR) cytogenetics but was associated with significantly higher toxicities.
Major finding: During a median follow-up of 35 months, event-free survival (hazard ratio [HR], 1.35; P = .116) and overall survival (HR, 1.35; P = .146) were not different in patients receiving GO+SC vs. SC alone. Duration of neutropenia (P = .03) and thrombopenia (P less than .001) and grade 3/4 liver toxicities (P = .03) were significantly higher in patients receiving GO vs. SC alone.
Study details: Phase 3 AML 2006-IR trial included 238 younger patients (age, 18-60 years) with de novo AML and IR cytogenetics randomly assigned to receive cytarabine and daunorubicin with or without GO. GO arm was prematurely closed after 254 inclusions because of toxicity and early deaths.
Disclosures: This study was supported by the French government PHRC 2006 and PFIZER group. Some investigators reported being on advisory boards, receiving research and travel funding, honoraria, and personal fees from various pharmaceutical companies, including Pfizer.
Source: Bouvier A et al. Eur J Haematol. 2021 Mar 25. doi: 10.1111/ejh.13626.
Key clinical point: The addition of gemtuzumab ozogamycin (GO) to standard chemotherapy (SC) did not improve survival in younger patients with de novo acute myeloid leukemia (AML) and intermediate-risk (IR) cytogenetics but was associated with significantly higher toxicities.
Major finding: During a median follow-up of 35 months, event-free survival (hazard ratio [HR], 1.35; P = .116) and overall survival (HR, 1.35; P = .146) were not different in patients receiving GO+SC vs. SC alone. Duration of neutropenia (P = .03) and thrombopenia (P less than .001) and grade 3/4 liver toxicities (P = .03) were significantly higher in patients receiving GO vs. SC alone.
Study details: Phase 3 AML 2006-IR trial included 238 younger patients (age, 18-60 years) with de novo AML and IR cytogenetics randomly assigned to receive cytarabine and daunorubicin with or without GO. GO arm was prematurely closed after 254 inclusions because of toxicity and early deaths.
Disclosures: This study was supported by the French government PHRC 2006 and PFIZER group. Some investigators reported being on advisory boards, receiving research and travel funding, honoraria, and personal fees from various pharmaceutical companies, including Pfizer.
Source: Bouvier A et al. Eur J Haematol. 2021 Mar 25. doi: 10.1111/ejh.13626.
Key clinical point: The addition of gemtuzumab ozogamycin (GO) to standard chemotherapy (SC) did not improve survival in younger patients with de novo acute myeloid leukemia (AML) and intermediate-risk (IR) cytogenetics but was associated with significantly higher toxicities.
Major finding: During a median follow-up of 35 months, event-free survival (hazard ratio [HR], 1.35; P = .116) and overall survival (HR, 1.35; P = .146) were not different in patients receiving GO+SC vs. SC alone. Duration of neutropenia (P = .03) and thrombopenia (P less than .001) and grade 3/4 liver toxicities (P = .03) were significantly higher in patients receiving GO vs. SC alone.
Study details: Phase 3 AML 2006-IR trial included 238 younger patients (age, 18-60 years) with de novo AML and IR cytogenetics randomly assigned to receive cytarabine and daunorubicin with or without GO. GO arm was prematurely closed after 254 inclusions because of toxicity and early deaths.
Disclosures: This study was supported by the French government PHRC 2006 and PFIZER group. Some investigators reported being on advisory boards, receiving research and travel funding, honoraria, and personal fees from various pharmaceutical companies, including Pfizer.
Source: Bouvier A et al. Eur J Haematol. 2021 Mar 25. doi: 10.1111/ejh.13626.
Does depth of clinical response pre-HCT affect posttransplant survival in AML?
Key clinical point: In patients with acute myeloid leukemia (AML), incomplete count recovery (CRi) or presence of measurable residual disease (MRD) before allogeneic hematopoietic cell transplantation (allo-HCT) was associated with inferior posttransplant outcomes vs. those in complete remission (CR) or without MRD.
Major finding: Patients in CRi vs. CR were at a higher risk for death (hazard ratio [HR], 1.27; P less than .001) and nonrelapse mortality (HR, 1.33; P = .002). Additionally, presence vs. absence of MRD was associated with shorter overall survival (HR, 1.52; P less than .001) and increased relapse (HR, 1.78; P less than .001).
Study details: This observational study included 2,492 adult patients with AML (CR, n=1,799; CRi, n=693) from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry, who underwent first allo-HCT between 2007 and 2015.
Disclosures: CIBMTR is primarily supported by the National Cancer Institute, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, Health Resources and Services Administration, and Office of Naval Research. The lead author had no disclosures. Some coinvestigators reported ties with various pharmaceutical companies.
Source: Percival ME et al. Bone Marrow Transplant. 2021 Apr 16. doi: 10.1038/s41409-021-01261-6.
Key clinical point: In patients with acute myeloid leukemia (AML), incomplete count recovery (CRi) or presence of measurable residual disease (MRD) before allogeneic hematopoietic cell transplantation (allo-HCT) was associated with inferior posttransplant outcomes vs. those in complete remission (CR) or without MRD.
Major finding: Patients in CRi vs. CR were at a higher risk for death (hazard ratio [HR], 1.27; P less than .001) and nonrelapse mortality (HR, 1.33; P = .002). Additionally, presence vs. absence of MRD was associated with shorter overall survival (HR, 1.52; P less than .001) and increased relapse (HR, 1.78; P less than .001).
Study details: This observational study included 2,492 adult patients with AML (CR, n=1,799; CRi, n=693) from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry, who underwent first allo-HCT between 2007 and 2015.
Disclosures: CIBMTR is primarily supported by the National Cancer Institute, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, Health Resources and Services Administration, and Office of Naval Research. The lead author had no disclosures. Some coinvestigators reported ties with various pharmaceutical companies.
Source: Percival ME et al. Bone Marrow Transplant. 2021 Apr 16. doi: 10.1038/s41409-021-01261-6.
Key clinical point: In patients with acute myeloid leukemia (AML), incomplete count recovery (CRi) or presence of measurable residual disease (MRD) before allogeneic hematopoietic cell transplantation (allo-HCT) was associated with inferior posttransplant outcomes vs. those in complete remission (CR) or without MRD.
Major finding: Patients in CRi vs. CR were at a higher risk for death (hazard ratio [HR], 1.27; P less than .001) and nonrelapse mortality (HR, 1.33; P = .002). Additionally, presence vs. absence of MRD was associated with shorter overall survival (HR, 1.52; P less than .001) and increased relapse (HR, 1.78; P less than .001).
Study details: This observational study included 2,492 adult patients with AML (CR, n=1,799; CRi, n=693) from the Center for International Blood and Marrow Transplantation Research (CIBMTR) registry, who underwent first allo-HCT between 2007 and 2015.
Disclosures: CIBMTR is primarily supported by the National Cancer Institute, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, Health Resources and Services Administration, and Office of Naval Research. The lead author had no disclosures. Some coinvestigators reported ties with various pharmaceutical companies.
Source: Percival ME et al. Bone Marrow Transplant. 2021 Apr 16. doi: 10.1038/s41409-021-01261-6.
Pediatric AML: Gemtuzumab ozogamicin prior to allo-HCT increases risk for veno-occlusive disease
Key clinical point: Prior treatment with gemtuzumab ozogamicin (GO) before allogeneic hematopoietic cell transplantation (allo-HCT) in pediatric patients with acute myeloid leukemia (AML) increased risk for veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) but did not affect survival.
Major finding: Compared with nonexposure, exposure to GO was associated with increased risk for VOD/SOS at 100 days (odds ratio, 2.26; P = .004). However, posttransplant overall survival (P = .43), disease-free survival (P = .20), relapse (P = .32), and nonrelapse mortality (P = .51) did not differ in patients with or without prior GO treatment.
Study details: Findings are from retrospective assessment of pediatric patients with AML who received myeloablative allo-HCT between 2008 and 2011 with (n=148) or without (n=348) prior GO treatment.
Disclosures: This study was funded by Pfizer. D Chirnomas, CJ Hoang, and FR Loberiza Jr declared being current/former employees of and/or had equity ownership in Pfizer. Other authors declared no conflicts of interest.
Source: Duncan C et al. Pediatr Blood Cancer. 2021 Apr 19. doi: 10.1002/pbc.29067.
Key clinical point: Prior treatment with gemtuzumab ozogamicin (GO) before allogeneic hematopoietic cell transplantation (allo-HCT) in pediatric patients with acute myeloid leukemia (AML) increased risk for veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) but did not affect survival.
Major finding: Compared with nonexposure, exposure to GO was associated with increased risk for VOD/SOS at 100 days (odds ratio, 2.26; P = .004). However, posttransplant overall survival (P = .43), disease-free survival (P = .20), relapse (P = .32), and nonrelapse mortality (P = .51) did not differ in patients with or without prior GO treatment.
Study details: Findings are from retrospective assessment of pediatric patients with AML who received myeloablative allo-HCT between 2008 and 2011 with (n=148) or without (n=348) prior GO treatment.
Disclosures: This study was funded by Pfizer. D Chirnomas, CJ Hoang, and FR Loberiza Jr declared being current/former employees of and/or had equity ownership in Pfizer. Other authors declared no conflicts of interest.
Source: Duncan C et al. Pediatr Blood Cancer. 2021 Apr 19. doi: 10.1002/pbc.29067.
Key clinical point: Prior treatment with gemtuzumab ozogamicin (GO) before allogeneic hematopoietic cell transplantation (allo-HCT) in pediatric patients with acute myeloid leukemia (AML) increased risk for veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) but did not affect survival.
Major finding: Compared with nonexposure, exposure to GO was associated with increased risk for VOD/SOS at 100 days (odds ratio, 2.26; P = .004). However, posttransplant overall survival (P = .43), disease-free survival (P = .20), relapse (P = .32), and nonrelapse mortality (P = .51) did not differ in patients with or without prior GO treatment.
Study details: Findings are from retrospective assessment of pediatric patients with AML who received myeloablative allo-HCT between 2008 and 2011 with (n=148) or without (n=348) prior GO treatment.
Disclosures: This study was funded by Pfizer. D Chirnomas, CJ Hoang, and FR Loberiza Jr declared being current/former employees of and/or had equity ownership in Pfizer. Other authors declared no conflicts of interest.
Source: Duncan C et al. Pediatr Blood Cancer. 2021 Apr 19. doi: 10.1002/pbc.29067.
De novo AML: Data spanning 4 decades show significant improvement in outcomes
Key clinical point: Survival outcomes have improved significantly in patients with de novo acute myeloid leukemia (AML) over a 4-decade period from 1980 to 2017; however, least improvement was observed in patients aged 70 years or older.
Major finding: Overall, 5-year survival increased from 9% during 1980-1989 to 15% in 1990-1999, 22% in 2000-2009, and 28% in 2010-2017 (all P less than .001). However, improvement in 5-year survival was poorest in patients aged 70 years or older with 1% in 1980-1989 to 5% in 2010-2017.
Study details: Findings are from a U.S. population-based study that evaluated 29,107 patients from the Surveillance, Epidemiology, and End Results registries, who were diagnosed with de novo AML between 1980 and 2017.
Disclosures: No funding source was identified. Some investigators including the lead author reported personal fees, research funding, honoraria, or other support from various pharmaceutical companies.
Source: Sasaki K et al. Cancer. 2021 Apr 5. doi: 10.1002/cncr.33458.
Key clinical point: Survival outcomes have improved significantly in patients with de novo acute myeloid leukemia (AML) over a 4-decade period from 1980 to 2017; however, least improvement was observed in patients aged 70 years or older.
Major finding: Overall, 5-year survival increased from 9% during 1980-1989 to 15% in 1990-1999, 22% in 2000-2009, and 28% in 2010-2017 (all P less than .001). However, improvement in 5-year survival was poorest in patients aged 70 years or older with 1% in 1980-1989 to 5% in 2010-2017.
Study details: Findings are from a U.S. population-based study that evaluated 29,107 patients from the Surveillance, Epidemiology, and End Results registries, who were diagnosed with de novo AML between 1980 and 2017.
Disclosures: No funding source was identified. Some investigators including the lead author reported personal fees, research funding, honoraria, or other support from various pharmaceutical companies.
Source: Sasaki K et al. Cancer. 2021 Apr 5. doi: 10.1002/cncr.33458.
Key clinical point: Survival outcomes have improved significantly in patients with de novo acute myeloid leukemia (AML) over a 4-decade period from 1980 to 2017; however, least improvement was observed in patients aged 70 years or older.
Major finding: Overall, 5-year survival increased from 9% during 1980-1989 to 15% in 1990-1999, 22% in 2000-2009, and 28% in 2010-2017 (all P less than .001). However, improvement in 5-year survival was poorest in patients aged 70 years or older with 1% in 1980-1989 to 5% in 2010-2017.
Study details: Findings are from a U.S. population-based study that evaluated 29,107 patients from the Surveillance, Epidemiology, and End Results registries, who were diagnosed with de novo AML between 1980 and 2017.
Disclosures: No funding source was identified. Some investigators including the lead author reported personal fees, research funding, honoraria, or other support from various pharmaceutical companies.
Source: Sasaki K et al. Cancer. 2021 Apr 5. doi: 10.1002/cncr.33458.
Clinical Edge Journal Scan Commentary: AML May 2021
Two recently published studies added to our knowledge on the clinical benefit of gemtuzumab in patients with AML. The first study by Bouvier A et al demonstrated no survival benefit with the addition of gemtuzumab in patients with intermediate risk AML. The second study by Duncan et al was a retrospective study by the CIBMTR. That study demonstrated increased risk of VOD in pediatric patients who received gemtuzmab. However, overall survival and event free survival was similar in both groups. These results highlight the need for increased awareness post-transplant for the possibility of VOD, and also reduces concern regarding overall survival for patients receiving gemtuzumab.
Another study by the EBMT (Debaja et al) evaluated factors affecting the outcome of patients with AML receiving a second allogeneic HCT. Outcome was worse for patients not in CR and those with a short time from allo-HCT. Overall survival was similar for patients receiving a MUD or haploidentical donor. Two year overall survival was 31% vs. 29% for patients receiving MUD vs. haploidentical allo-HCT. This study clearly expands options for patients receiving a second allo-HCT. In addition, a prior study by EBMT demonstrated no difference in overall survival between patients receiving same vs. different vs. haplo donor.
Finally, a large study by the CIBMTR (Percival et al) demonstrated that in AML patients, achieving CRi and having persistent MRD prior to transplantation were associated with worse outcome compared to CR with no evidence of MRD. The adjusted 5 year survival for patient with CR/MRD-ve, CR/MRD+ve, CRi/MRD-ve and CRi/MRD+ve was 52%, 37%, 44% and 34% respectively.
Two recently published studies added to our knowledge on the clinical benefit of gemtuzumab in patients with AML. The first study by Bouvier A et al demonstrated no survival benefit with the addition of gemtuzumab in patients with intermediate risk AML. The second study by Duncan et al was a retrospective study by the CIBMTR. That study demonstrated increased risk of VOD in pediatric patients who received gemtuzmab. However, overall survival and event free survival was similar in both groups. These results highlight the need for increased awareness post-transplant for the possibility of VOD, and also reduces concern regarding overall survival for patients receiving gemtuzumab.
Another study by the EBMT (Debaja et al) evaluated factors affecting the outcome of patients with AML receiving a second allogeneic HCT. Outcome was worse for patients not in CR and those with a short time from allo-HCT. Overall survival was similar for patients receiving a MUD or haploidentical donor. Two year overall survival was 31% vs. 29% for patients receiving MUD vs. haploidentical allo-HCT. This study clearly expands options for patients receiving a second allo-HCT. In addition, a prior study by EBMT demonstrated no difference in overall survival between patients receiving same vs. different vs. haplo donor.
Finally, a large study by the CIBMTR (Percival et al) demonstrated that in AML patients, achieving CRi and having persistent MRD prior to transplantation were associated with worse outcome compared to CR with no evidence of MRD. The adjusted 5 year survival for patient with CR/MRD-ve, CR/MRD+ve, CRi/MRD-ve and CRi/MRD+ve was 52%, 37%, 44% and 34% respectively.
Two recently published studies added to our knowledge on the clinical benefit of gemtuzumab in patients with AML. The first study by Bouvier A et al demonstrated no survival benefit with the addition of gemtuzumab in patients with intermediate risk AML. The second study by Duncan et al was a retrospective study by the CIBMTR. That study demonstrated increased risk of VOD in pediatric patients who received gemtuzmab. However, overall survival and event free survival was similar in both groups. These results highlight the need for increased awareness post-transplant for the possibility of VOD, and also reduces concern regarding overall survival for patients receiving gemtuzumab.
Another study by the EBMT (Debaja et al) evaluated factors affecting the outcome of patients with AML receiving a second allogeneic HCT. Outcome was worse for patients not in CR and those with a short time from allo-HCT. Overall survival was similar for patients receiving a MUD or haploidentical donor. Two year overall survival was 31% vs. 29% for patients receiving MUD vs. haploidentical allo-HCT. This study clearly expands options for patients receiving a second allo-HCT. In addition, a prior study by EBMT demonstrated no difference in overall survival between patients receiving same vs. different vs. haplo donor.
Finally, a large study by the CIBMTR (Percival et al) demonstrated that in AML patients, achieving CRi and having persistent MRD prior to transplantation were associated with worse outcome compared to CR with no evidence of MRD. The adjusted 5 year survival for patient with CR/MRD-ve, CR/MRD+ve, CRi/MRD-ve and CRi/MRD+ve was 52%, 37%, 44% and 34% respectively.