Consolidation chemotherapy intensity does not affect outcomes for older adults with AML
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Intensive consolidation chemotherapy prior to allogeneic hematopoietic stem cell transplant provided no greater benefit than nonintensive consolidation for older adults with acute myeloid leukemia, according to study results.
Allogeneic HSCT is the optimal curative treatment for adults with AML.
Approximately 60% to 70% of older patients who undergo intensive induction chemotherapy achieve complete remission; however, there is no consensus regarding consolidation treatment for elderly patients with AML in first complete remission prior to allogeneic stem cell transplant, according to study background presented at Society of Hematologic Oncology Annual Meeting.
Yosr Hicheri, MD, of Institut Paoli Calmettes in France, and colleagues conducted a retrospective study of 130 patients with AML aged 60 years or older who underwent transplant between 2007 and 2017.
All patients achieved first complete remission after intensive induction.
Sixty-eight patients (52.3%; median age, 63 years; range, 60-72; 79% de novo AML) underwent intensive consolidation chemotherapy prior to allogeneic stem cell transplant. The other 62 patients (47.7%; median age, 66 years; range, 60-72; 77% de novo AML) underwent nonintensive consolidation.
A higher percentage of patients in the intensive consolidation chemotherapy group had favorable-risk (10% vs. 2%), intermediate-risk (43% vs. 32%) or adverse-risk (31% vs. 29%) disease classification per European LeukemiaNet 2017 criteria. Data were missing for 37% of those who received nonintensive consolidation and 16% of those who received intensive consolidation.
Time from diagnosis to transplant, as well as donor types, appeared comparable between groups.
RFS served as the primary efficacy outcome.
Median follow-up was 52.2 months.
Researchers observed no difference in RFS at 2 years between the intensive and nonintensive groups (51% vs. 50%).
However, rates of 2-year RFS did differ significantly between patients with favorable-risk or intermediate-risk classification and those with unfavorable-risk classification (56% vs. 34%; P = .01).
Results showed no difference in nonrelapse mortality at 2 years between the intensive and nonintensive consolidation groups (27% vs. 16%).
Collapse
Bardol JK, et al. Abstract AML-112. Presented at: Society of Hematologic Oncology Annual Meeting; Sept. 6-9, 2023; Houston.
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