Ten-year outcome of patients with acute myeloid leukemia not treated with allogeneic transplantation in first complete remission

Vasu, Sumithira; Kohlschmidt, Jessica; Mrozek, Krzysztof; Eisfeld, Ann-Kathrin; Nicolet, Deedra; Sterling, Lisa J.; Becker, Heiko; Metzeler, Klaus H.; Papaioannou, Dimitrios; Powell, Bayard L.; Kolitz, Jonathan E.; Moore, Joseph O.; Bär, Maria R.; Roboz, Gail J.; Stone, Richard M.; Byrd, John C.; Carroll, Andrew J. and Bloomfield, Clara D. (2018): Ten-year outcome of patients with acute myeloid leukemia not treated with allogeneic transplantation in first complete remission. In: Blood Advances, Vol. 2, No. 13: pp. 1645-1650

Abstract

The probability that adult patients with de novo acute myeloid leukemia (AML) receiving intensive chemotherapy in the absence of allogeneic hematopoietic stem cell transplantation (Allo-HCT) in first complete remission (CR1) will be disease-free at 10 years after diagnosis, a long-term surrogate of cure, is unknown. To address this question, we examined 2551 AML patients (1607 aged <60 years, and 944 aged >= 60 years) enrolled in Cancer and Leukemia Group B treatment protocols and the cytogenetics companion protocol 8461 between 1983 and 2004. At 10 years, 267 (16.6%) of patients aged <60 years and 23 (2.4%) of those aged >= 60 years were alive and disease-free. This disease-free AML group consisted predominantly of patients with core-binding factor AML with t(8;21)(q22;q22) or inv(16)(p13q22)/t(16;16)(p13;q22) and those with a normal karyotype. Occurrences of AML beyond 10 years were infrequent and associated with cytogenetic findings different from those at diagnosis. These data provide evidence that the frequency of long-term cure of AML is low among younger and especially older patients in the absence of Allo-HCT in CR1. In older patients not appropriate for Allo-HCT, these data provide further justification for early use of alternative treatments outside of intensive chemotherapy.

• Item Type: Journal article
• Faculties: Medicine
• Subjects: 600 Technology > 610 Medicine and health
• ISSN: 2473-9529
• Language: English