Transplant-ineligible AML: CR after first induction chemotherapy is tied HDC/IL-2 relapse benefit

  • Nilsson MS & al.
  • Br J Haematol
  • 18 Dec 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In adult patients with acute myeloid leukemia (AML) ineligible for allogeneic stem cell transplantation (allo-SCT), complete remission (CR) with the first cycle of induction therapy was linked to improved survival outcomes with relapse-preventive histamine dihydrochloride/interleukin 2 (HDC/IL-2).

Why this matters

  • Relapse after induction/consolidation chemotherapy is a major cause of mortality.

Study design

  • Phase 3 study to investigate associations between the efficiency of previous induction chemotherapy and the efficacy of relapse-preventive HDC/IL-2 in 320 patients with AML ineligible for allo-SCT.
  • Patients in CR after consolidation were randomly assigned to receive HDC/IL-2 or no treatment.
  • Funding: None disclosed.

Key results

  • Among 260 evaluable patients, 78% achieved CR1 after induction cycle 1.
  • In patients achieving CR1 with induction cycle 1:
    • Significant improvement in leukemia-free survival (LFS) with HDC/IL-2 (P=.01).
    • A trend toward improved OS with HDC/IL-2 (P=.09).
  • In patients aged
  • Significant improvement in LFS with HDC/IL-2 (P=.001).
  • Significant improvement in OS with HDC/IL-2 (P=.02).
  • In patients requiring >1 induction cycle to achieve CR1:
    • No significant difference in LFS (P=.64).
    • No significant difference in OS (P=.84).
  • Limitations

    • The limited sample size for subgroup analyses.