AML: immediate reinduction no advantage in patients with indeterminate day 14 bone marrow results

  • Jamy O & al.
  • Clin Lymphoma Myeloma Leuk
  • 28 Sep 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with newly diagnosed acute myeloid leukemia (AML) in whom day 14 bone marrow (BM) results were indeterminate regarding response to induction therapy, immediate reinduction delivered no significant advantage over observation in terms of overall response, median OS, or relapse-free survival (RFS).

Why this matters

  • 10%-40% of patients in this setting fail to achieve complete remission with anthracycline-containing induction therapy.

Study design

  • Study to investigate observation (n=25) vs immediate reinduction (n=25) in 50 patients with newly diagnosed AML who had indeterminate BM results in their day 14 scan for response to induction.
  • Median patient age, 57 (range, 19-73) years.
  • 48% of each group had poor risk disease per cytogenetic and molecular abnormalities.
  • Funding: None disclosed.

Key results

  • No significant difference between treatment groups in:
    • Overall response: 80% for both groups (P=1.0).
    • Median OS: 13 months with reinduction vs 21 months with observation (P=.88).
    • RFS: 13 months with reinduction vs 33 months with observation (P=.53).

Limitations

  • Limited sample size.