|The following article features coverage from the American Society of Clinical Oncology 2019 meeting. Click here to read more of Hematology Advisor’s conference coverage.|
High-intensity induction chemotherapy may be effective in driving complete remission (CR) without measurable residual disease (MRD) in acute myeloid leukemia (AML), but broader impacts of high-intensity induction CT on survival have been unclear, according to research presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
The study suggested that chemotherapy induction intensity may not impart additional survival benefits beyond a relationship with MRD negativity for patients with AML.
In this retrospective analysis of patients with newly diagnosed AML or myelodysplastic syndrome and 10% to 20% blasts, patients were grouped as having undergone high-intensity (217 patients) or low-intensity (38 patients) induction. A total of 10 patients had also received allogeneic hematopoietic cell transplant (HCT) after remission.
Bone marrow MRD status was evaluated using multiparameter flow cytometry during the first 2 weeks after achieving CR. The researchers performed a multivariate analysis of several factors to evaluate any associations with treatment outcomes. In addition to MRD status and chemotherapy induction intensity, factors included age, performance status, baseline cytogenetics, and de novo or secondary status of AML.
The high-intensity induction group reached CR without MRD at a much higher rate (75%) compared with the low-intensity induction group (42%). However, an apparent relationship between OS and induction intensity was not robust when considering the other covariates (hazard ratio, 0.94; 95% CI, 0.58-1.52; P =.8).
Presence of MRD was associated with lower OS whether or not high-intensity induction was used.
The authors concluded that high-intensity induction chemotherapy likely affected outcomes in AML through influencing MRD negativity and reported that further evaluation will include more patients exposed to HCT.
- Hochman MJ, Othus M, Shaw C, et al. Does intensity of induction chemotherapy affect the impact of measurable residual disease (MRD) on prognosis in acute myeloid leukemia (AML)? Poster presentation at: 2019 ASCO Annual Meeting; June 3, 2019; Chicago, IL. Abstract 7031.