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.
Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy / Mosna, F; Borlenghi, E; Litzow, M; Byrd, J. C.; Papayannidis, C; Tecchio, C; Ferrara, F; Marcucci, G; Cairoli, R; Morgan, E. A.; Gurrieri, C; Yeung C., Cs; Deeg, H. J.; Capelli, D; Candoni, A; Gotlib, J. R.; Lunghi, M; Pullarkat, S; Lanza, F; Galimberti, S; Forghieri, F; Venditti, A; Festuccia, M; Audisio, E; Marvalle, D; Rigolin, G. M.; Roti, G; Dibona, E; Visani, G; Albano, F; Eisfeld, A. K.; Valent, P; Huls, G; Borthakur, G; Krampera, M; Martinelli, G; Kroger, N; Sperotto, A; Gottardi, M. - In: HAEMATOLOGICA. - ISSN 0390-6078. - 110:3(2025), pp. 608-620. [10.3324/haematol.2024.285448]
Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy
Roti G;
2025-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
