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Predicting outcomes in therapy-related AML
Therapy-related acute myeloid leukemia (t-AML) occurs as a complication of chemotherapy and/or radiotherapy for previous cancer or for nonmalignant disorders, with an estimated prevalence of 10%-15% of all AML cases, according to Ram Vasudevan Nampoothiri, MD, and colleagues at the Princess Margaret Cancer Center, University of Toronto.
Dr. Nampoothiri and colleagues performed a retrospective study of 68 patients with t-AML who underwent hematopoietic stem cell transplantation (HSCT) at their institution. They found significant predictors of reduced overall survival, including chromosomal rearrangements, induction regimens, donor type, patient performance status, and the type of graft-versus-host disease (GVHD) prophylaxis the patients received, as reported in Hematology/Oncology and Stem Cell Therapy.
Some populations benefit
Among the 68 patients studied, a total of 59.9% were women; and the median age was 56.5 years. All patients were analyzed for prior malignancy, therapy, time to diagnosis of t-AML, transplant details, relapse-free survival, overall survival, and predictors of outcomes.
At 2 years, the cumulative incidence of relapse, nonrelapse mortality, relapse-free survival, and overall survival were 17.9%, 34.5%, 47.6%, and 49.3%, respectively. Overall, acute and chronic GVHD occurred in 39 (57.4%) and 23 (33.8%) patients, respectively, according to the researchers.
The significant predictors of reduced overall survival were the presence of the 11q23 chromosomal rearrangement (hazard ratio, 3.24), use of induction regimens other than fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor or 7 + 3 (HR, 3.65), use of haploidentical donors (HR, 3.48), an Eastern Cooperative Oncology Group performance status of 2 or higher (HR, 5.83), and use of cyclosporine A–methotrexate as GVHD prophylaxis (HR, 2.41).
The researchers also found that a significant decrease in survival was seen with an increasing number of any of these prognostic factors.
A growing need
The incidence of t-AML is increasing because of longer life expectancy of the general population and also because of the improved survival of patients treated with chemotherapy and/or radiation for prior malignancies, according to the researchers.
They concluded that, even with this increasing prevalence and normally poor prognosis, “patients of t-AML having good-risk karyotypes, good performance status, and having HLA-matched donors have favorable outcomes after allo-HSCT.”
The authors reported that they had no competing financial interests.
Therapy-related acute myeloid leukemia (t-AML) occurs as a complication of chemotherapy and/or radiotherapy for previous cancer or for nonmalignant disorders, with an estimated prevalence of 10%-15% of all AML cases, according to Ram Vasudevan Nampoothiri, MD, and colleagues at the Princess Margaret Cancer Center, University of Toronto.
Dr. Nampoothiri and colleagues performed a retrospective study of 68 patients with t-AML who underwent hematopoietic stem cell transplantation (HSCT) at their institution. They found significant predictors of reduced overall survival, including chromosomal rearrangements, induction regimens, donor type, patient performance status, and the type of graft-versus-host disease (GVHD) prophylaxis the patients received, as reported in Hematology/Oncology and Stem Cell Therapy.
Some populations benefit
Among the 68 patients studied, a total of 59.9% were women; and the median age was 56.5 years. All patients were analyzed for prior malignancy, therapy, time to diagnosis of t-AML, transplant details, relapse-free survival, overall survival, and predictors of outcomes.
At 2 years, the cumulative incidence of relapse, nonrelapse mortality, relapse-free survival, and overall survival were 17.9%, 34.5%, 47.6%, and 49.3%, respectively. Overall, acute and chronic GVHD occurred in 39 (57.4%) and 23 (33.8%) patients, respectively, according to the researchers.
The significant predictors of reduced overall survival were the presence of the 11q23 chromosomal rearrangement (hazard ratio, 3.24), use of induction regimens other than fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor or 7 + 3 (HR, 3.65), use of haploidentical donors (HR, 3.48), an Eastern Cooperative Oncology Group performance status of 2 or higher (HR, 5.83), and use of cyclosporine A–methotrexate as GVHD prophylaxis (HR, 2.41).
The researchers also found that a significant decrease in survival was seen with an increasing number of any of these prognostic factors.
A growing need
The incidence of t-AML is increasing because of longer life expectancy of the general population and also because of the improved survival of patients treated with chemotherapy and/or radiation for prior malignancies, according to the researchers.
They concluded that, even with this increasing prevalence and normally poor prognosis, “patients of t-AML having good-risk karyotypes, good performance status, and having HLA-matched donors have favorable outcomes after allo-HSCT.”
The authors reported that they had no competing financial interests.
Therapy-related acute myeloid leukemia (t-AML) occurs as a complication of chemotherapy and/or radiotherapy for previous cancer or for nonmalignant disorders, with an estimated prevalence of 10%-15% of all AML cases, according to Ram Vasudevan Nampoothiri, MD, and colleagues at the Princess Margaret Cancer Center, University of Toronto.
Dr. Nampoothiri and colleagues performed a retrospective study of 68 patients with t-AML who underwent hematopoietic stem cell transplantation (HSCT) at their institution. They found significant predictors of reduced overall survival, including chromosomal rearrangements, induction regimens, donor type, patient performance status, and the type of graft-versus-host disease (GVHD) prophylaxis the patients received, as reported in Hematology/Oncology and Stem Cell Therapy.
Some populations benefit
Among the 68 patients studied, a total of 59.9% were women; and the median age was 56.5 years. All patients were analyzed for prior malignancy, therapy, time to diagnosis of t-AML, transplant details, relapse-free survival, overall survival, and predictors of outcomes.
At 2 years, the cumulative incidence of relapse, nonrelapse mortality, relapse-free survival, and overall survival were 17.9%, 34.5%, 47.6%, and 49.3%, respectively. Overall, acute and chronic GVHD occurred in 39 (57.4%) and 23 (33.8%) patients, respectively, according to the researchers.
The significant predictors of reduced overall survival were the presence of the 11q23 chromosomal rearrangement (hazard ratio, 3.24), use of induction regimens other than fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor or 7 + 3 (HR, 3.65), use of haploidentical donors (HR, 3.48), an Eastern Cooperative Oncology Group performance status of 2 or higher (HR, 5.83), and use of cyclosporine A–methotrexate as GVHD prophylaxis (HR, 2.41).
The researchers also found that a significant decrease in survival was seen with an increasing number of any of these prognostic factors.
A growing need
The incidence of t-AML is increasing because of longer life expectancy of the general population and also because of the improved survival of patients treated with chemotherapy and/or radiation for prior malignancies, according to the researchers.
They concluded that, even with this increasing prevalence and normally poor prognosis, “patients of t-AML having good-risk karyotypes, good performance status, and having HLA-matched donors have favorable outcomes after allo-HSCT.”
The authors reported that they had no competing financial interests.
FROM HEMATOLOGY/ONCOLOGY AND STEM CELL THERAPY
Clinical Edge Commentary: AML April 2021
In a study by Trembely et al. sponsored by Pfizer, an indirect comparison of both studies was performed using a simulated treatment comparison to account for differences in patient characteristics. As expected, the overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46). This study demonstrates again that CR/CRi cannot be used as a surrogate endpoint for survival in AML. In addition, with the negative study of V-LDAC vs. LDAC and the improved overall survival of the combination of azacytidine + venetoclax (Aza-ven) vs. azacitdine, the current standard of care of newly diagnosed patients with AML unbale to tolerate intensive chemotherapy is Aza-ven and V-LDAC is rarely used.
The success of Aza-ven is not without side effects. This was demonstrated recently in a retrospective study by Feld et al. In that study 72 patients with newly diagnosed AML (26), relapsed refractory AML (39) and MDS (7) received azacitdine + venetoclax. The main side effect was myelosuppression with only 15% of patients who were transfusion dependent become transfusion independent. In addition, 46% of patients had a neutropenic fever and 43.7% of patients requiring admission. Most patients (54.9%) required treatment interruption and 35.2% stopped venetoclax for toxicity.
This study highlighted that the optimal dose and frequency of venetoclax remains unclear. A shorted duration or lower dose of venetoclax maybe more ideal, however that may lead to less efficacy. In addition, bone marrow evaluation to assess for cellularity on D21 to D28 of the first cycle may help guide dose adjustments. Finally with the high CR/CRi rates in AML and short duration of response further studies are ongoing to further define molecular abnormalities that may refine prognosis or guide therapy. Two of those studies recently reported identified a prognostic and possible therapeutic role for both EZH2 and the PI3 kinase mTOR pathway.
In a study by Trembely et al. sponsored by Pfizer, an indirect comparison of both studies was performed using a simulated treatment comparison to account for differences in patient characteristics. As expected, the overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46). This study demonstrates again that CR/CRi cannot be used as a surrogate endpoint for survival in AML. In addition, with the negative study of V-LDAC vs. LDAC and the improved overall survival of the combination of azacytidine + venetoclax (Aza-ven) vs. azacitdine, the current standard of care of newly diagnosed patients with AML unbale to tolerate intensive chemotherapy is Aza-ven and V-LDAC is rarely used.
The success of Aza-ven is not without side effects. This was demonstrated recently in a retrospective study by Feld et al. In that study 72 patients with newly diagnosed AML (26), relapsed refractory AML (39) and MDS (7) received azacitdine + venetoclax. The main side effect was myelosuppression with only 15% of patients who were transfusion dependent become transfusion independent. In addition, 46% of patients had a neutropenic fever and 43.7% of patients requiring admission. Most patients (54.9%) required treatment interruption and 35.2% stopped venetoclax for toxicity.
This study highlighted that the optimal dose and frequency of venetoclax remains unclear. A shorted duration or lower dose of venetoclax maybe more ideal, however that may lead to less efficacy. In addition, bone marrow evaluation to assess for cellularity on D21 to D28 of the first cycle may help guide dose adjustments. Finally with the high CR/CRi rates in AML and short duration of response further studies are ongoing to further define molecular abnormalities that may refine prognosis or guide therapy. Two of those studies recently reported identified a prognostic and possible therapeutic role for both EZH2 and the PI3 kinase mTOR pathway.
In a study by Trembely et al. sponsored by Pfizer, an indirect comparison of both studies was performed using a simulated treatment comparison to account for differences in patient characteristics. As expected, the overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46). This study demonstrates again that CR/CRi cannot be used as a surrogate endpoint for survival in AML. In addition, with the negative study of V-LDAC vs. LDAC and the improved overall survival of the combination of azacytidine + venetoclax (Aza-ven) vs. azacitdine, the current standard of care of newly diagnosed patients with AML unbale to tolerate intensive chemotherapy is Aza-ven and V-LDAC is rarely used.
The success of Aza-ven is not without side effects. This was demonstrated recently in a retrospective study by Feld et al. In that study 72 patients with newly diagnosed AML (26), relapsed refractory AML (39) and MDS (7) received azacitdine + venetoclax. The main side effect was myelosuppression with only 15% of patients who were transfusion dependent become transfusion independent. In addition, 46% of patients had a neutropenic fever and 43.7% of patients requiring admission. Most patients (54.9%) required treatment interruption and 35.2% stopped venetoclax for toxicity.
This study highlighted that the optimal dose and frequency of venetoclax remains unclear. A shorted duration or lower dose of venetoclax maybe more ideal, however that may lead to less efficacy. In addition, bone marrow evaluation to assess for cellularity on D21 to D28 of the first cycle may help guide dose adjustments. Finally with the high CR/CRi rates in AML and short duration of response further studies are ongoing to further define molecular abnormalities that may refine prognosis or guide therapy. Two of those studies recently reported identified a prognostic and possible therapeutic role for both EZH2 and the PI3 kinase mTOR pathway.
Bone marrow cells contribute to AML disease environment
Key clinical point: Bone marrow stromal cells in patients with myelodysplastic syndromes and acute myeloid leukemia showed a reduced frequency of colony forming unit-fibroblasts.
Major finding: The frequencies of positive/positive bone marrow stromal cells were significantly lower in AML patient samples compared to healthy individuals and MDS bone marrow samples. The median cell numbers of bone marrow stromal cells in diagnostic samples were 3,200 for healthy samples, 476 for MDS samples, and 70 for AML samples.
Study details: The data come from bone marrow samples in AML patients, MDS patients, and healthy donors.
Disclosures: The study was supported in part by Projekt DEAL and the Deutsche Forschungsgemeinschaft SFB 1243 for projects A09 and the FOR2033 project B3, as well as the Deutsche Jose Carreras Leukämie Stiftung. The researchers had no financial conflicts to disclose.
Source: Weickert M-T et al. Sci Rep. 2021 Mar 15. doi: 10.1038/s41598-021-85122-8.
Key clinical point: Bone marrow stromal cells in patients with myelodysplastic syndromes and acute myeloid leukemia showed a reduced frequency of colony forming unit-fibroblasts.
Major finding: The frequencies of positive/positive bone marrow stromal cells were significantly lower in AML patient samples compared to healthy individuals and MDS bone marrow samples. The median cell numbers of bone marrow stromal cells in diagnostic samples were 3,200 for healthy samples, 476 for MDS samples, and 70 for AML samples.
Study details: The data come from bone marrow samples in AML patients, MDS patients, and healthy donors.
Disclosures: The study was supported in part by Projekt DEAL and the Deutsche Forschungsgemeinschaft SFB 1243 for projects A09 and the FOR2033 project B3, as well as the Deutsche Jose Carreras Leukämie Stiftung. The researchers had no financial conflicts to disclose.
Source: Weickert M-T et al. Sci Rep. 2021 Mar 15. doi: 10.1038/s41598-021-85122-8.
Key clinical point: Bone marrow stromal cells in patients with myelodysplastic syndromes and acute myeloid leukemia showed a reduced frequency of colony forming unit-fibroblasts.
Major finding: The frequencies of positive/positive bone marrow stromal cells were significantly lower in AML patient samples compared to healthy individuals and MDS bone marrow samples. The median cell numbers of bone marrow stromal cells in diagnostic samples were 3,200 for healthy samples, 476 for MDS samples, and 70 for AML samples.
Study details: The data come from bone marrow samples in AML patients, MDS patients, and healthy donors.
Disclosures: The study was supported in part by Projekt DEAL and the Deutsche Forschungsgemeinschaft SFB 1243 for projects A09 and the FOR2033 project B3, as well as the Deutsche Jose Carreras Leukämie Stiftung. The researchers had no financial conflicts to disclose.
Source: Weickert M-T et al. Sci Rep. 2021 Mar 15. doi: 10.1038/s41598-021-85122-8.
Transfusion reliance remains after AML treatment with VEN and HMA
Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.
Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.
Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.
Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose.
Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.
Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.
Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.
Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.
Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose.
Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.
Key clinical point: Treatment with a combination of venetoclax (VEN) and hypomethylating agents (HMA) may be an option for younger AML patients, but myelosuppression was a concern, and 43.7% of treated patients were hospitalized for a treatment-related adverse event.
Major finding: In the 26 newly-diagnosed AML patients, the complete remission rate was 53.8%, but only 38.5% in the 39 relapsed/refractory patients; however, 70% remained dependent on red blood cell transfusion and 58.6% remained dependent on platelet transfusion during and after treatment.
Study details: The data come from 65 patients with acute myeloid leukemia and 7 patients with myelodysplastic syndrome who were treated with a combination of VEN and HMA.
Disclosures: The study’s corresponding author was supported by the National Institutes of Health and the National Cancer Institute. Lead author Dr. Feld had no financial conflicts to disclose.
Source: Feld J et al. Hemasphere. 2021 Mar 9. doi: 10.1097/HS9.0000000000000549.
Loss of tumor suppressor may drive cytarabine resistance in AML
Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.
Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.
Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.
Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose.
Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.
Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.
Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.
Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.
Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose.
Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.
Key clinical point: Mutations promoting loss of function in the histone methyltransferase EZH2 are relatively rare but may promote chemoresistance to the treatment agent cytarabine in patients with acute myeloid leukemia.
Major finding: In cell lines and in patient samples, AML patients, loss of function of EZH2 fostered resistance to cytarabine; the EZH2 mutation was present in 4% of AML patients at diagnosis; low expression of EZH2 mRNA was correlated with poor overall survival and relapse-free survival.
Study details: The data come from a combination of patient samples, in vivo and in vitro patient-derived xenografts, and haematopeoietic cell lines, and included 25 patients with an EZH2 mutation at the time of diagnosis.
Disclosures: The study was supported by Projekt DEAL. The researchers had no financial conflicts to disclose.
Source: Kempf JM et al. Sci Rep. 2021 Mar 12. doi: 10.1038/s41598-021-84708-6.
Gene mutation status impacts overall survival in acute myeloid leukemia
Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.
Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.
Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia.
Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose.
Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.
Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.
Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.
Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia.
Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose.
Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.
Key clinical point: Gene set variation analysis (GSVA) showed that the PI3K-Akt-mTOR pathway was positively related to FLT3-ITD mutation.
Major finding: In patients with acute myeloid leukemia, expression of RPS6KA1 and AP2M1 were predictors of chemoresistance and overall survival.
Study details: The data come from four genetic data sets: GSE6891, GSE10358, GSE15434, and GSE61804 of patients with acute myeloid leukemia.
Disclosures: The study was supported by the Young & Middle-aged Medical Key Talents Training Project of Wuhan. The researchers had no financial conflicts to disclose.
Source: Yu D-H et al. Front Cell Dev Biol. 2021 Feb 26. doi: 10.3389/fcell.2021.641629.
Glasdegib and venetoclax show similar success for AML
Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.
Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).
Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.
Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.
Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.
Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.
Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).
Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.
Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.
Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.
Key clinical point: For AML patients unable to undergo intensive chemotherapy, glasdegib and venetoclax were similarly effective, each in combination with low-dose cytarabine.
Major finding: Overall response rates were higher in the venetoclax study compared to the glasdegib study (48% vs. 24%), but overall survival was similar (hazard ratio 0.75 vs. HR 0.46).
Study details: The data come an indirect comparison of studies of each treatment: the BRIGHT AML 1003 GLAS+LDAC trial, and the VIALE-C VEN+LDAC trial.
Disclosures: The study was sponsored by Pfizer. Several researchers are Pfizer employees and lead author Dr. Tremblay served as a paid consultant to Pfizer during the study.
Source: Tremblay G et al. J Comp Eff Res. 2021 Mar 18. doi: 10.2217/cer-2020-0280.
Venetoclax succeeds for AML remission in untreated older patients
Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.
Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.
Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.
Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose.
Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.
Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.
Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.
Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.
Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose.
Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.
Key clinical point: Venetoclax combination therapy was safe and effective in older adults with acute myeloid leukemia who had not been previously treated.
Major finding: A total of 12 patients achieved complete remission, and another 4 patients achieved complete remission with incomplete blood recovery, with a median response duration of 8.9 months; however, response duration dropped to 4.6 months for patients with adverse cytogenetic risk.
Study details: The data come from 19 consecutive patients with a median age of 77 years and previously untreated AML who received venetoclax combination therapy at a single center; 12 of these received a starting dose of 400 mg daily, 4 received 200 mg, and 3 patients received 100 mg.
Disclosures: The study was supported by the Ligue Nationale Contre le Cancer, and the association Laurette Fugain. The researchers had no financial conflicts to disclose.
Source: Vazquez R et al. Blood Cancer J. 2021 Mar 19. doi: 10.1038/s41408-021-00448-w.
Green tea extract promotes immune system function in older AML patients
Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.
Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8+ T cells, perforin+/granzyme B+ natural killer cells, monocytes, and classical monocytes.
Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.
Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose.
Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.
Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.
Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8+ T cells, perforin+/granzyme B+ natural killer cells, monocytes, and classical monocytes.
Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.
Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose.
Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.
Key clinical point: Green tea extract was safely tolerated and associated with improved immune modulation regardless of tumor burden in older acute myeloid leukemia patients on low-dose chemotherapy.
Major finding: After 30 days, older adults with acute myeloid leukemia who consumed green tea extract showed an increase in total and CD8+ T cells, perforin+/granzyme B+ natural killer cells, monocytes, and classical monocytes.
Study details: The data come from 10 patients aged 60 years and older with acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) who received two capsules of green tea extract for a 1,000-mg daily dose for at least 6 months.
Disclosures: The study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico, the Fundação de Amparo à Pesquisa do Estado de São Paulo, and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. The researchers had no financial conflicts to disclose.
Source: Calgarotto AK et al. Integr Cancer Ther. 2021 Mar 23. doi:10.1177/15347354211002647.
Early tumor cell response predicts AML treatment success
Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.
Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,
Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.
Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose.
Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.
Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.
Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,
Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.
Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose.
Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.
Key clinical point: Treatment regimen was a key factor in survival rates among adults with acute myeloid leukemia, and patients with high responsiveness of tumor cells in vitro showed stronger response to chemotherapy.
Major finding: Patients with high sensitivity to daunorubicin showed a good response to anthracycline‐based therapy; by contrast, patients who received daunorubicin during induction chemotherapy as part of standard clinical care, but who did not sensitivity to it, responded poorly to treatment,
Study details: The data come from a retrospective analysis of survival rates in 127 adults with acute myeloid leukemia.
Disclosures: The study was funded by the Russian Science Foundation and the Russian State Budget Project of ICBFM SB RAS. The researchers had no financial conflicts to disclose.
Source: Kolesnikova MA et al. Cancer Rep. 2021 Mar 6. doi: 10.1002/cnr2.1362.