Clinical Implications of Condensing HDAC Regimen in Treatment of AML
Posted: Thursday, September 17, 2020
Christian Récher, MD, PhD, Head of the Hematology Department of the Institut Universitaire du Cancer de Toulouse, France, and colleagues retrospectively compared the delivery of high-dose cytarabine every 12 hours on days 1, 3, and 5 (HDAC-135)—the standard-of-care consolidation regimen for acute myeloid leukemia (AML)—with a condensed regimen on days 1, 2, and 3 (HDAC-123). In younger patients with AML in first response, although the condensed regimen appeared to induce a quicker hematologic recovery, with a related reduction in the length of hospital stay, it did not seem to affect treatment response or outcome. These study findings were published in Blood Advances.
“Patients receiving the HDAC-123 regimen spent 9 days less in the hospital over the whole period of postremission treatment,” commented the study authors. “Clinically relevant durations of leukopenia, neutropenia, and thrombocytopenia were significantly shortened by 3 to 4 days with the use of the HDAC-123 regimen compared with the HDAC-135 regimen.”
A total of 221 patients, with a median age of 46.6 years, were included in the study. As consolidation treatment in first complete response, HDAC-123 was given to 92 patients, and HDAC-135 was given to 129 patients.
The investigators observed similar rates of relapse-free survival, cumulative incidence of relapse, nonrelapsed mortality, and overall survival in both groups of patients. However, patients who received the condensed HDAC-123 regimen had a shorter hematologic recovery time (regarding neutrophils and platelets), with an average difference of between 3 and 4 days for each consolidation cycle. Furthermore, those given HDAC-123 had a shorter total duration of hospitalization for the entire postremission program than did that given HDAC-135 (32 vs. 42 days, P < .0001).
Disclosure: For full disclosures of the study authors, visit ashpublications.org.