AML

Key clinical point: Addition of tosedostat to low-dose cytosine arabinoside (LDAC) did not confer any additional clinical benefit compared with LDAC alone in older patients with acute myeloid leukemia (AML) unfit for intensive chemotherapy.

Major finding: There was no significant benefit of adding tosedostat to LDAC vs. LDAC alone on overall response (25% vs. 18%; P = .22) and 2-year overall survival (16% vs. 12%; P = .8). Overall rates of grade 3 or higher toxicity were low, but diarrhea and cardiac toxicity were significantly higher with tosedostat.

Study details: Findings are from LI-1 trial including 243 older (age, 60 years or older) patients with de novo or secondary AML or high-risk myelodysplastic syndrome who were unfit for intensive chemotherapy. Patients were randomly allocated to receive either LDAC (n=121) or LDAC+tosedostat (n=122).

Disclosures: This study was supported by CTI Biopharma, Blood Cancer UK, the Haematology Clinical Trials Unit, and the Centre for Trials Research, Cardiff University. No author disclosures were reported.

Source: Dennis M et al. Br J Haematol. 2021 May 7. doi: 10.1111/bjh.17501.

Key clinical point: Addition of tosedostat to low-dose cytosine arabinoside (LDAC) did not confer any additional clinical benefit compared with LDAC alone in older patients with acute myeloid leukemia (AML) unfit for intensive chemotherapy.

Major finding: There was no significant benefit of adding tosedostat to LDAC vs. LDAC alone on overall response (25% vs. 18%; P = .22) and 2-year overall survival (16% vs. 12%; P = .8). Overall rates of grade 3 or higher toxicity were low, but diarrhea and cardiac toxicity were significantly higher with tosedostat.

Study details: Findings are from LI-1 trial including 243 older (age, 60 years or older) patients with de novo or secondary AML or high-risk myelodysplastic syndrome who were unfit for intensive chemotherapy. Patients were randomly allocated to receive either LDAC (n=121) or LDAC+tosedostat (n=122).

Disclosures: This study was supported by CTI Biopharma, Blood Cancer UK, the Haematology Clinical Trials Unit, and the Centre for Trials Research, Cardiff University. No author disclosures were reported.

Source: Dennis M et al. Br J Haematol. 2021 May 7. doi: 10.1111/bjh.17501.

Key clinical point: Addition of tosedostat to low-dose cytosine arabinoside (LDAC) did not confer any additional clinical benefit compared with LDAC alone in older patients with acute myeloid leukemia (AML) unfit for intensive chemotherapy.

Major finding: There was no significant benefit of adding tosedostat to LDAC vs. LDAC alone on overall response (25% vs. 18%; P = .22) and 2-year overall survival (16% vs. 12%; P = .8). Overall rates of grade 3 or higher toxicity were low, but diarrhea and cardiac toxicity were significantly higher with tosedostat.

Study details: Findings are from LI-1 trial including 243 older (age, 60 years or older) patients with de novo or secondary AML or high-risk myelodysplastic syndrome who were unfit for intensive chemotherapy. Patients were randomly allocated to receive either LDAC (n=121) or LDAC+tosedostat (n=122).

Disclosures: This study was supported by CTI Biopharma, Blood Cancer UK, the Haematology Clinical Trials Unit, and the Centre for Trials Research, Cardiff University. No author disclosures were reported.

Source: Dennis M et al. Br J Haematol. 2021 May 7. doi: 10.1111/bjh.17501.

Key clinical point: In the absence of human leukocyte antigen-matched donors, allogeneic hematopoietic cell transplantation (allo-HCT) using a mismatched unrelated donor (MMUD) with posttransplant cyclophosphamide (PTCy) yielded better survival outcomes vs. cord blood transplantation (CBT) in patients with acute myeloid leukemia (AML).

Major finding: CBT was associated with a significantly higher risk for nonrelapse mortality (adjusted hazard ratio [aHR], 2.09), worse leukemia-free survival (aHR, 1.68), and overall survival (aHR, 1.70) vs. MMUD (all P less than .0001).

Study details: This study included adult patients with AML who underwent a first allo-HCT using CBT (n=902) or single-allele MMUD with PTCy (n=280) between 2010 and 2019.

Disclosures: No funding source was disclosed. The authors declared no conflicts of interest.

Source: Dholaria B et al. J Hematol Oncol. 2021 May 3. doi: 10.1186/s13045-021-01086-2.

Key clinical point: In the absence of human leukocyte antigen-matched donors, allogeneic hematopoietic cell transplantation (allo-HCT) using a mismatched unrelated donor (MMUD) with posttransplant cyclophosphamide (PTCy) yielded better survival outcomes vs. cord blood transplantation (CBT) in patients with acute myeloid leukemia (AML).

Major finding: CBT was associated with a significantly higher risk for nonrelapse mortality (adjusted hazard ratio [aHR], 2.09), worse leukemia-free survival (aHR, 1.68), and overall survival (aHR, 1.70) vs. MMUD (all P less than .0001).

Study details: This study included adult patients with AML who underwent a first allo-HCT using CBT (n=902) or single-allele MMUD with PTCy (n=280) between 2010 and 2019.

Disclosures: No funding source was disclosed. The authors declared no conflicts of interest.

Source: Dholaria B et al. J Hematol Oncol. 2021 May 3. doi: 10.1186/s13045-021-01086-2.

Key clinical point: In the absence of human leukocyte antigen-matched donors, allogeneic hematopoietic cell transplantation (allo-HCT) using a mismatched unrelated donor (MMUD) with posttransplant cyclophosphamide (PTCy) yielded better survival outcomes vs. cord blood transplantation (CBT) in patients with acute myeloid leukemia (AML).

Major finding: CBT was associated with a significantly higher risk for nonrelapse mortality (adjusted hazard ratio [aHR], 2.09), worse leukemia-free survival (aHR, 1.68), and overall survival (aHR, 1.70) vs. MMUD (all P less than .0001).

Study details: This study included adult patients with AML who underwent a first allo-HCT using CBT (n=902) or single-allele MMUD with PTCy (n=280) between 2010 and 2019.

Disclosures: No funding source was disclosed. The authors declared no conflicts of interest.

Source: Dholaria B et al. J Hematol Oncol. 2021 May 3. doi: 10.1186/s13045-021-01086-2.

Several studies published this month have shed some more light on the treatment and prognosis of certain molecular subgroups such as FLT3, spliceasome mutations and IDH mutation. A study from MD Anderson Cancer Center (MDACC) demonstrated the efficacy of FLT33 inhibitors in the treatment of patients with very low allelic burden. Patients who recived both a FMS-like tyrosine kinase inhibitor (FLT3i) during induction and an allogeneic HCT at time of first remission had better 5 year overall survival (OS) (100%) than those who received neither (27%). The 5-year OS rate among patients who did not receive FLT3i-based induction but underwent allo-SCT in CR1 was 71%. None of the patients who received a FLT3i had detectable FLT3 at time of relapse, compared to 67% for those who did not. The main weakness of the study is the small number of patients (total of 50 patients). This study however does provide some provocative data regarding the validity of the FLT3 allelic ratio in decisions regarding treatment and prognosis. The results of this study need to be validated in a larger cohort of patients.

A study by Lachowiez et al, further refined the prognostic significance of spliceosome mutations in patients treated with ven + HMA. Of the 119 patients, 39 had spliceosome mutations. The overall response and prognosis was not different between patients with and without spliceosome mutations. However, SRSF2 was associated with IDH2 mutation and the median OS was not reached vs, patient with U2AF1 who had a higher association with RAS mutations (OS 8 months). The prognostic role of standard cytotoxic chemotherapy in improving the outcome of patients with an IDH mutation was studied by the group. In a re-evaluation of the randomized trial comparing the addition of fludarabine or cladrbaine to standard 7 +3, 50 patients with an IDH mutation were evaluated. Patients with an IDH mutation who received cladribine. IDH2 mutation had a positive impact on OS in patients treated with DAC regimen (54% vs. 33%; P = .0087) but not in those treated with daunorubicin+cytarabine (DA; 21% vs. 23%; P = .22) regimen. Moreover, DAC induction was independently associated with a reduced risk for death when the observations were censored at allogeneic hematopoietic stem cell transplant (hazard ratio, 0.21; P = .02).

Although hypomethylating agents + venetoclax (HMA +ven) have shown efficacy in multiple patient subgroups, the outcome of patients with post-MPN acute myeloid leukemia (AML) remains poor even with HMA + ven. In a retrospective study, 31 patients with post MPN AML were treated with HMA + ven. The overall survival for patients with relapsed post MPN AML was 3 months with none of the 9 patients achieving a CR/CRi. As for the patients with previously untreated post MPN-AML, the median survival was still poor at 8 months with 43% achieving CR/CRi. This study highlights the large unmet need in this patient population. In comparison, in a retrospective study by Piccini et al, of the 47 patients with relapsed/refractory (R/R) AML treated with venetoclax based regimens the composite CR rate was 55%. These outcomes are similar to other studies of venetoclax based regimens in patients with R/R AML. 

In a retrospective study from the European Society for Blood and Marrow Transplantation (EBMT) registry, the outcomes of patients receiving mismatched unrelated donor (MMUD) with post transplant cyclophosphamide (PTCy) had better outcomes compared to patients receiving cord blood transplantation (CBT). The 2 year leukemia free survival (LFS) for CBT vs MMUD was 42.8% vs 60.5% and OS was 46.85 vs 62.8%. This retrospective study demonstrated that PTCy can improve the outcomes of patients receiving of MMUD (Dholaria B et al. J Hematol Oncol. 2021 May).

Several studies published this month have shed some more light on the treatment and prognosis of certain molecular subgroups such as FLT3, spliceasome mutations and IDH mutation. A study from MD Anderson Cancer Center (MDACC) demonstrated the efficacy of FLT33 inhibitors in the treatment of patients with very low allelic burden. Patients who recived both a FMS-like tyrosine kinase inhibitor (FLT3i) during induction and an allogeneic HCT at time of first remission had better 5 year overall survival (OS) (100%) than those who received neither (27%). The 5-year OS rate among patients who did not receive FLT3i-based induction but underwent allo-SCT in CR1 was 71%. None of the patients who received a FLT3i had detectable FLT3 at time of relapse, compared to 67% for those who did not. The main weakness of the study is the small number of patients (total of 50 patients). This study however does provide some provocative data regarding the validity of the FLT3 allelic ratio in decisions regarding treatment and prognosis. The results of this study need to be validated in a larger cohort of patients.

A study by Lachowiez et al, further refined the prognostic significance of spliceosome mutations in patients treated with ven + HMA. Of the 119 patients, 39 had spliceosome mutations. The overall response and prognosis was not different between patients with and without spliceosome mutations. However, SRSF2 was associated with IDH2 mutation and the median OS was not reached vs, patient with U2AF1 who had a higher association with RAS mutations (OS 8 months). The prognostic role of standard cytotoxic chemotherapy in improving the outcome of patients with an IDH mutation was studied by the group. In a re-evaluation of the randomized trial comparing the addition of fludarabine or cladrbaine to standard 7 +3, 50 patients with an IDH mutation were evaluated. Patients with an IDH mutation who received cladribine. IDH2 mutation had a positive impact on OS in patients treated with DAC regimen (54% vs. 33%; P = .0087) but not in those treated with daunorubicin+cytarabine (DA; 21% vs. 23%; P = .22) regimen. Moreover, DAC induction was independently associated with a reduced risk for death when the observations were censored at allogeneic hematopoietic stem cell transplant (hazard ratio, 0.21; P = .02).

Although hypomethylating agents + venetoclax (HMA +ven) have shown efficacy in multiple patient subgroups, the outcome of patients with post-MPN acute myeloid leukemia (AML) remains poor even with HMA + ven. In a retrospective study, 31 patients with post MPN AML were treated with HMA + ven. The overall survival for patients with relapsed post MPN AML was 3 months with none of the 9 patients achieving a CR/CRi. As for the patients with previously untreated post MPN-AML, the median survival was still poor at 8 months with 43% achieving CR/CRi. This study highlights the large unmet need in this patient population. In comparison, in a retrospective study by Piccini et al, of the 47 patients with relapsed/refractory (R/R) AML treated with venetoclax based regimens the composite CR rate was 55%. These outcomes are similar to other studies of venetoclax based regimens in patients with R/R AML. 

In a retrospective study from the European Society for Blood and Marrow Transplantation (EBMT) registry, the outcomes of patients receiving mismatched unrelated donor (MMUD) with post transplant cyclophosphamide (PTCy) had better outcomes compared to patients receiving cord blood transplantation (CBT). The 2 year leukemia free survival (LFS) for CBT vs MMUD was 42.8% vs 60.5% and OS was 46.85 vs 62.8%. This retrospective study demonstrated that PTCy can improve the outcomes of patients receiving of MMUD (Dholaria B et al. J Hematol Oncol. 2021 May).

Several studies published this month have shed some more light on the treatment and prognosis of certain molecular subgroups such as FLT3, spliceasome mutations and IDH mutation. A study from MD Anderson Cancer Center (MDACC) demonstrated the efficacy of FLT33 inhibitors in the treatment of patients with very low allelic burden. Patients who recived both a FMS-like tyrosine kinase inhibitor (FLT3i) during induction and an allogeneic HCT at time of first remission had better 5 year overall survival (OS) (100%) than those who received neither (27%). The 5-year OS rate among patients who did not receive FLT3i-based induction but underwent allo-SCT in CR1 was 71%. None of the patients who received a FLT3i had detectable FLT3 at time of relapse, compared to 67% for those who did not. The main weakness of the study is the small number of patients (total of 50 patients). This study however does provide some provocative data regarding the validity of the FLT3 allelic ratio in decisions regarding treatment and prognosis. The results of this study need to be validated in a larger cohort of patients.

A study by Lachowiez et al, further refined the prognostic significance of spliceosome mutations in patients treated with ven + HMA. Of the 119 patients, 39 had spliceosome mutations. The overall response and prognosis was not different between patients with and without spliceosome mutations. However, SRSF2 was associated with IDH2 mutation and the median OS was not reached vs, patient with U2AF1 who had a higher association with RAS mutations (OS 8 months). The prognostic role of standard cytotoxic chemotherapy in improving the outcome of patients with an IDH mutation was studied by the group. In a re-evaluation of the randomized trial comparing the addition of fludarabine or cladrbaine to standard 7 +3, 50 patients with an IDH mutation were evaluated. Patients with an IDH mutation who received cladribine. IDH2 mutation had a positive impact on OS in patients treated with DAC regimen (54% vs. 33%; P = .0087) but not in those treated with daunorubicin+cytarabine (DA; 21% vs. 23%; P = .22) regimen. Moreover, DAC induction was independently associated with a reduced risk for death when the observations were censored at allogeneic hematopoietic stem cell transplant (hazard ratio, 0.21; P = .02).

Although hypomethylating agents + venetoclax (HMA +ven) have shown efficacy in multiple patient subgroups, the outcome of patients with post-MPN acute myeloid leukemia (AML) remains poor even with HMA + ven. In a retrospective study, 31 patients with post MPN AML were treated with HMA + ven. The overall survival for patients with relapsed post MPN AML was 3 months with none of the 9 patients achieving a CR/CRi. As for the patients with previously untreated post MPN-AML, the median survival was still poor at 8 months with 43% achieving CR/CRi. This study highlights the large unmet need in this patient population. In comparison, in a retrospective study by Piccini et al, of the 47 patients with relapsed/refractory (R/R) AML treated with venetoclax based regimens the composite CR rate was 55%. These outcomes are similar to other studies of venetoclax based regimens in patients with R/R AML. 

In a retrospective study from the European Society for Blood and Marrow Transplantation (EBMT) registry, the outcomes of patients receiving mismatched unrelated donor (MMUD) with post transplant cyclophosphamide (PTCy) had better outcomes compared to patients receiving cord blood transplantation (CBT). The 2 year leukemia free survival (LFS) for CBT vs MMUD was 42.8% vs 60.5% and OS was 46.85 vs 62.8%. This retrospective study demonstrated that PTCy can improve the outcomes of patients receiving of MMUD (Dholaria B et al. J Hematol Oncol. 2021 May).

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.

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.

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.

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.

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.

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.

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.