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Cytarabine dose intensification improves survival in older patients with secondary/high-risk acute myeloid leukemia in matched real-world versus clinical trial data

Abé, Christoph ; Keto, Jaana ; Lilja, Mathias ; Konradsen, Mie ; Mesterton, Johan ; Höglund, Martin ; Lazarevic, Vladimir LU ; Lehmann, Sören and Juliusson, Gunnar LU (2024) In Leukemia and Lymphoma
Abstract

Since 1980’s, the established/standard treatment of acute myeloid leukemia (AML) is cytarabine infusion with anthracycline (7 + 3 regimen). We compared the 7 + 3 regimen in older secondary/high-risk AML patientsfrom a clinical trial with a matched population from the Swedish AML Registrytreated withan increased cytarabine dose in induction and consolidation as recommended in the Swedish National Guidelines since 2005. After successfulpropensity score matching, 104 patients per group were included. The primary outcome was overall survival (OS), and standard dosed patients had a median OS of 6.4 versus 10.7 months with increased dose intensity (hazard ratio:0.69, p = 0.012), with 5-year OS of 8.7% and 18.1%, andremission rates of 36% and... (More)

Since 1980’s, the established/standard treatment of acute myeloid leukemia (AML) is cytarabine infusion with anthracycline (7 + 3 regimen). We compared the 7 + 3 regimen in older secondary/high-risk AML patientsfrom a clinical trial with a matched population from the Swedish AML Registrytreated withan increased cytarabine dose in induction and consolidation as recommended in the Swedish National Guidelines since 2005. After successfulpropensity score matching, 104 patients per group were included. The primary outcome was overall survival (OS), and standard dosed patients had a median OS of 6.4 versus 10.7 months with increased dose intensity (hazard ratio:0.69, p = 0.012), with 5-year OS of 8.7% and 18.1%, andremission rates of 36% and 60%, respectively (p < 0.001). Median OS after allogeneic hematopoietic cell transplantation (in 27.9% per group) was 10.4 and 20.7 months, respectively. We conclude that the more intensive cytarabine schedule seems to provide improved outcomes inthe investigated AML patient group.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Conventional 7 + 3 regimen, external control arm, hematopoietic cell transplantation, overall survival, real-world data, standard of care
in
Leukemia and Lymphoma
publisher
Taylor & Francis
external identifiers
  • pmid:38861379
  • scopus:85195549323
ISSN
1042-8194
DOI
10.1080/10428194.2024.2363430
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 Informa UK Limited, trading as Taylor & Francis Group.
id
3c089537-923a-439e-8310-82e4a292229e
date added to LUP
2024-06-19 16:08:24
date last changed
2024-07-03 16:52:40
@article{3c089537-923a-439e-8310-82e4a292229e,
  abstract     = {{<p>Since 1980’s, the established/standard treatment of acute myeloid leukemia (AML) is cytarabine infusion with anthracycline (7 + 3 regimen). We compared the 7 + 3 regimen in older secondary/high-risk AML patientsfrom a clinical trial with a matched population from the Swedish AML Registrytreated withan increased cytarabine dose in induction and consolidation as recommended in the Swedish National Guidelines since 2005. After successfulpropensity score matching, 104 patients per group were included. The primary outcome was overall survival (OS), and standard dosed patients had a median OS of 6.4 versus 10.7 months with increased dose intensity (hazard ratio:0.69, p = 0.012), with 5-year OS of 8.7% and 18.1%, andremission rates of 36% and 60%, respectively (p &lt; 0.001). Median OS after allogeneic hematopoietic cell transplantation (in 27.9% per group) was 10.4 and 20.7 months, respectively. We conclude that the more intensive cytarabine schedule seems to provide improved outcomes inthe investigated AML patient group.</p>}},
  author       = {{Abé, Christoph and Keto, Jaana and Lilja, Mathias and Konradsen, Mie and Mesterton, Johan and Höglund, Martin and Lazarevic, Vladimir and Lehmann, Sören and Juliusson, Gunnar}},
  issn         = {{1042-8194}},
  keywords     = {{Conventional 7 + 3 regimen; external control arm; hematopoietic cell transplantation; overall survival; real-world data; standard of care}},
  language     = {{eng}},
  publisher    = {{Taylor & Francis}},
  series       = {{Leukemia and Lymphoma}},
  title        = {{Cytarabine dose intensification improves survival in older patients with secondary/high-risk acute myeloid leukemia in matched real-world versus clinical trial data}},
  url          = {{http://dx.doi.org/10.1080/10428194.2024.2363430}},
  doi          = {{10.1080/10428194.2024.2363430}},
  year         = {{2024}},
}