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Rebecca Olin, MD, MS

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Induction Strategy and SCT Outcomes in Older Patients With AML

By: Vanessa A. Carter, BS
Posted: Wednesday, July 13, 2022

A study conducted by Faustine Ong, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues planned to identify the optimal induction regimen for elderly patients with acute myeloid leukemia (AML) who underwent stem cell transplantation (SCT). Presented during the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 7038), these results concluded that lower-intensity therapy with venetoclax was, in fact, a valid induction strategy for this patient population.

This retrospective analysis focused on 127 patients aged 60 and older with newly diagnosed AML who underwent allogeneic SCT. Participants were stratified depending on induction therapy received: lower-intensity therapy with venetoclax (n = 47), intensive chemotherapy (n = 44), and lower-intensity therapy without venetoclax (n = 36).

Most individuals who underwent lower-intensity therapy with venetoclax received reduced-intensity conditioning prior to SCT (92%). Additionally, many patients in each group achieved a complete response prior to undergoing SCT; other patients had a morphologic leukemia-free state as best response. Of note, the rate of measurable residual disease negativity was highest in the lower-intensity therapy with venetoclax group (69%), followed by the intensive chemotherapy (58%) and lower-intensity therapy without venetoclax (49%) groups.

The median follow-up was 37 months, and the 2-year cumulative incidence of relapse was higher among individuals receiving lower-intensity therapy without venetoclax (36%) than those receiving venetoclax (19%) or undergoing intensive chemotherapy (18%). Furthermore, the 2-year nonrelapse mortality was the lowest in patients on lower-intensity therapy with venetoclax when compared with the other cohorts. Notably, the 1- and 2-year relapse-free survivals were highest among individuals on lower-intensity therapy with venetoclax, followed by those who received intensive chemotherapy and lower-intensity therapy without venetoclax; overall survival rates demonstrated similar trends.

“Despite the older age of patients in the lower-intensity therapy with venetoclax cohort, their post-stem cell therapy survival outcomes were noninferior, and possibly superior, to those who received intensive chemotherapy,” concluded the investigators.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.


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