Intensity of consolidation chemotherapy before allogeneic hematopoietic stem cell transplantation (SCT) did not appear to impact survival in a study of older patients with acute myeloid leukemia (AML). The study results were described at the SOHO 2023 Annual Meeting in an oral presentation by Yosr Hicheri, MD, of the Institut Paoli Clamettes in Marseilles, France, and colleagues.
The study was a retrospective analysis that evaluated outcomes in patients with AML who were 60 years of age or older who were in first complete remission (CR1) and receiving allogeneic SCT. The main study outcome was to determine relapse-free survival (RFS) rates in patients according to whether they had received intensive or nonintensive consolidation chemotherapy before allogeneic SCT.
There were 130 patients included in the study, of whom 68 had been given intensive consolidation chemotherapy, while 62 had received nonintensive consolidation chemotherapy. Patients were evaluated at a median follow-up time of 52.2 months.
Following allogeneic SCT, the 2-year RFS rate was 51% in the group receiving intensive treatment, which was similar to a rate of 50% for patients in the group receiving nonintensive treatment (P =.546). The 2 treatment groups also showed similar 2-year overall survival rates, which were 52% and 58%, respectively (P =.729).
Additionally, nonrelapse mortality rates at 2 years did not show statistically significant results between the groups (27% and 16%, respectively; P =.564). Graft vs host disease rates also did not appear to be significantly impacted by intensity of consolidation chemotherapy.
A multivariate analysis identified cytogenetic risk as a prognostic factor in this study. Patients with adverse cytogenetics had a 2-year RFS rate of 34%, compared with 56% among patients who had favorable or intermediate cytogenetic status (P =.01).
“The main takeaway from this study is that there is no impact of intensive versus nonintensive consolidation before hematopoietic stem cell transplantation in AML over 60 years old in CR1,” Dr Hicheri said in her presentation.
The research team also noted the study had certain limitations related to its retrospective nature and they highlighted a range of strategies that have potential to improve treatment options for patients.
Bardol JK, Devillier R, Ceballos P, et al. Impact of consolidation chemotherapy intensity before allogeneic hematopoietic stem cell transplantation in elderly patients with acute myeloid leukemia. Presented at: the Eleventh Annual Meeting of the Society of Hematologic Oncology (SOHO) ; September 6-9, 2023; Abstract AML-112.