1. Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy
- Author
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Mosna, F, Borlenghi, E, Litzow, M, Byrd, J, Papayannidis, C, Tecchio, C, Ferrara, F, Marcucci, G, Cairoli, R, Morgan, E, Gurrieri, C, Yeung, C, Deeg, H, Capelli, D, Candoni, A, Gotlib, J, Lunghi, M, Pullarkat, S, Lanza, F, Galimberti, S, Forghieri, F, Venditti, A, Festuccia, M, Audisio, E, Marvalle, D, Rigolin, G, Roti, G, Dibona, E, Visani, G, Albano, F, Eisfeld, A, Valent, P, Huls, G, Borthakur, G, Krampera, M, Martinelli, G, Kröger, N, Sperotto, A, Gottardi, M, Mosna, Federico, Borlenghi, Erika, Litzow, Mark, Byrd, John C, Papayannidis, Cristina, Tecchio, Cristina, Ferrara, Felicetto, Marcucci, Guido, Cairoli, Roberto, Morgan, Elizabeth A, Gurrieri, Carmela, Yeung, Cecilia C S, Deeg, H Joachim, Capelli, Debora, Candoni, Anna, Gotlib, Jason R, Lunghi, Monia, Pullarkat, Sheeja, Lanza, Francesco, Galimberti, Sara, Forghieri, Fabio, Venditti, Adriano, Festuccia, Moreno, Audisio, Ernesta, Marvalle, Denise, Rigolin, Gian Matteo, Roti, Giovanni, DiBona, Eros, Visani, Giuseppe, Albano, Francesco, Eisfeld, Ann-Kathrin, Valent, Peter, Huls, Gerwin, Borthakur, Gautam, Krampera, Mauro, Martinelli, Giovanni, Kröger, Nicolaus, Sperotto, Alessandra, Gottardi, Michele, Mosna, F, Borlenghi, E, Litzow, M, Byrd, J, Papayannidis, C, Tecchio, C, Ferrara, F, Marcucci, G, Cairoli, R, Morgan, E, Gurrieri, C, Yeung, C, Deeg, H, Capelli, D, Candoni, A, Gotlib, J, Lunghi, M, Pullarkat, S, Lanza, F, Galimberti, S, Forghieri, F, Venditti, A, Festuccia, M, Audisio, E, Marvalle, D, Rigolin, G, Roti, G, Dibona, E, Visani, G, Albano, F, Eisfeld, A, Valent, P, Huls, G, Borthakur, G, Krampera, M, Martinelli, G, Kröger, N, Sperotto, A, Gottardi, M, Mosna, Federico, Borlenghi, Erika, Litzow, Mark, Byrd, John C, Papayannidis, Cristina, Tecchio, Cristina, Ferrara, Felicetto, Marcucci, Guido, Cairoli, Roberto, Morgan, Elizabeth A, Gurrieri, Carmela, Yeung, Cecilia C S, Deeg, H Joachim, Capelli, Debora, Candoni, Anna, Gotlib, Jason R, Lunghi, Monia, Pullarkat, Sheeja, Lanza, Francesco, Galimberti, Sara, Forghieri, Fabio, Venditti, Adriano, Festuccia, Moreno, Audisio, Ernesta, Marvalle, Denise, Rigolin, Gian Matteo, Roti, Giovanni, DiBona, Eros, Visani, Giuseppe, Albano, Francesco, Eisfeld, Ann-Kathrin, Valent, Peter, Huls, Gerwin, Borthakur, Gautam, Krampera, Mauro, Martinelli, Giovanni, Kröger, Nicolaus, Sperotto, Alessandra, and Gottardi, Michele
- Abstract
Acute Myeloid Leukemia is mainly a disease of the elderly: however, the knowledge on the outcomes of treatment in core binding factor AML (CBFAML) in older population, is limited. We retrospectively collected data on 229 patients with CBF- AML followed long-term in the last two decades. A 5-year overall survival (OS) of 44.2% (95%CI, 39.9-47.5) and a 5-year event - free survival (EFS) of 32.9% (95%CI, 25.5-40.1) was observed. In a subgroup of >70-year patients who completed intensive therapy (induction + >3 courses of consolidation including autologous stem cell transplant: 10 patients) the median EFS was 11.8 months (95%CI, 9.4 - 15.2) and OS was 40.0% (95%CI, 36.4 - 44.1) at 5yr. In univariate analysis, age >70 (hazard ratio (HR) 1.78, [95%CI, 1.15 - 2.54], p=.008), failure to achieve remission following induction (HR, 8.96 [95%CI, 5.5 - 13.8], p=<.0001), no consolidation therapy (HR, 0.75 [95%CI, 0.47 - 1.84], p=.04) and less than 3 cycles of consolidation (HR, 1.48 [95%CI, 0.75 - 3.2], p=.0004), predicted poorer EFS. Our study shows that intensive therapy, in selected older CBF-AML patients, leads to longer survival. Achieving a CR seems to be the most important first step and at least 3 cycles of consolidation, an important second one. The analysis suggests that these patients should not be excluded from studies with intensive therapies.
- Published
- 2024