scholarly journals Hypomethylating Agent/Venetoclax Versus Intensive Chemotherapy in Relapsed or Refractory Acute Myeloid Leukemia

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2322-2322
Author(s):  
Omer Hassan Jamy ◽  
Sarah Worth ◽  
Sravanti Rangaraju ◽  
Kimo Bachiashvili ◽  
Pankit Vachhani ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Risk Stratification ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
High Dose ◽  
University Of Alabama ◽  
Significant Difference ◽  
Acute Myeloid

Abstract Background: Patients with relapsed or refractory (r/r) acute myeloid leukemia (AML) have limited treatment options. Outside of clinical trials and in the absence of a targetable mutation, there is no consensus on an optimal treatment regimen. Venetoclax (Ven), combined with hypomethylating agents (HMA) such as azacitadine (Aza) or decitabine (Dec), is approved as frontline treatment for elderly or unfit patients with AML. HMA/Ven is also being used frequently in the salvage setting. However, outcomes of HMA/Ven compared to IC for patients with r/r AML are largely unknown. Methods: We conducted a retrospective study to compare outcomes of adult patients (>18y) with r/r AML treated with either HMA/Ven or IC at the University of Alabama at Birmingham. Patients treated with HMA/Ven were matched in a 1:1 ratio to patients receiving IC following a hierarchal algorithm based on age, ELN risk stratification, time to relapse (primary refractory/<6m vs. ≥6m) and line of therapy. Treatment with HMA consisted of either Aza 75mg/m 2 for 7 days or Dec 20mg/m 2 for 5 days. Venetoclax was administered at an effective dose of 400mg daily for 21-28 days per cycle (dose adjusted for concomitant azole use). Results: There were 74 patients included in the analysis (HMA/Ven=37, IC=37). The baseline characteristics (Table 1) were well balanced with the exception of increased bone marrow blast percentage in the IC arm (59% vs. 39%, p=0.03). The median age of the IC and HMA/Ven groups was 56y (24-72y) and 63y (22-75y), respectively (p=0.06). Regimens in the IC arm included FLAG (n=16, 43%), FLAG-ida (n=11, 30%), CLAG-M (n=5, 14%), 7+3 (n=3, 8%), HiDAC (n=1, 2.5%) and MEC (n=1, 2.5%). In the HMA/Ven arm, 21 patients (57%) received Aza and 16 (43%) received Dec. The rate of complete remission (CR) was higher for IC (49% vs. 24%, p=0.02) whereas rate of CR with incomplete count recovery (CRi) was higher for HMA/Ven (35% vs. 8%, p=0.001) (Table 2). There was no difference in composite CR (CR+CRi) rates between the two arms (IC 57% vs. 59% HMA/Ven, p=0.8). Additionally, there was no difference in rate of refractory disease (27% vs. 27%, p=0.9) or 30-day mortality (IC 13% vs 11% HMA/Ven, p=0.6) between the two arms. More patients in the IC arm (41%), compared to the HMA/Ven (19%) arm proceeded to allogeneic stem cell transplantation (allo-sct) (p=0.04). The median overall survival (mOS) for the IC arm was 16m, compared to 8m for the HMA/Ven arm (p=0.1) (Figure 1). The mOS for patients with primary refractory/<6m relapse from remission was 10m for IC and 6m for HMA/Ven (p=0.4). The mOS for patients refractory to one cycle of intensive induction (7+3 in approximately 90% cases in both arms) was 20m for the IC arm and 5m for the HMA/Ven arm (p=0.03) (Figure 2). The mOS for patients relapsing ≥6m from remission was 15m for IC and 9m for HMA/Ven (p=0.5). There was no difference in survival based on age, ELN risk stratification or cytogenetics. Conclusion: Overall, there appears to be no significant difference in outcomes between IC and HMA/Ven for patients with r/r AML. Higher CR rates as well as ability to proceed to allo-sct are observed with IC. For patients refractory to the first cycle of intensive induction chemotherapy, a significant survival benefit was observed in those receiving IC compared to HMA/Ven. A second round of induction, preferably with a high-dose cytarabine based regimen, may provide better long term outcomes for these patients. Figure 1 Figure 1. Disclosures Vachhani: CTI BioPharma Corp: Consultancy; Abbvie: Consultancy; Agios: Consultancy; Blueprint Medicines: Consultancy; Pfizer: Consultancy; Seattle Genetics: Research Funding; Astellas Pharma: Speakers Bureau; Incyte: Consultancy, Speakers Bureau; Novartis: Consultancy; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham: Current Employment; Jazz Pharmaceuticals: Consultancy.

Safety and feasibility of outpatient high-dose cytarabine and intermediate-dose cytarabine for consolidation therapy in acute myeloid leukemia

2021 ◽  
pp. 107815522110465
Author(s):  
Wenhui Li ◽  
Katherine Richter ◽  
Jamie Lee ◽  
Kevin McCarthy ◽  
Timothy Kubal
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Outpatient Setting ◽  
Cancer Center ◽  
High Dose ◽  
Consolidation Therapy ◽  
High Dose Cytarabine ◽  
Incidence Of Hospitalization ◽  
Acute Myeloid ◽  
Intermediate Dose

Introduction The standard of care consolidation therapy for acute myeloid leukemia is high-dose cytarabine or intermediate-dose cytarabine, which are traditionally given inpatient. At Moffitt Cancer Center, we have moved the administration of high-dose cytarabine and intermediate-dose cytarabine to the outpatient setting through the inpatient/outpatient program. To facilitate outpatient administration, high-dose cytarabine and intermediate-dose cytarabine are given in a shorter interval of every 10 h instead of 12 h. The safety of a shorter duration interval of high-dose cytarabine and intermediate-dose cytarabine is unknown. This study aims to assess the safety and feasibility of administering high-dose cytarabine and intermediate-dose cytarabine consolidation therapy in the inpatient/outpatient setting. Methods This is a retrospective chart review to analyze acute myeloid leukemia patients treated with inpatient/outpatient high-dose cytarabine or intermediate-dose cytarabine consolidation therapy at Moffitt Cancer Center from January 1, 2015, through November 1, 2018. The primary objective was to determine the incidence of hospitalization during the inpatient/outpatient administration of high-dose cytarabine or intermediate-dose cytarabine. Results Two hundred fifty-three of 255 cycles of high-dose cytarabine/intermediate-dose cytarabine were delivered outpatient over the reviewed time period to 118 patients. No patients receiving outpatient high-dose cytarabine/intermediate-dose cytarabine consolidation required hospitalization during chemotherapy. Our incidence of hospitalization (24%) after chemotherapy is consistent with the reported literature. Through the inpatient/outpatient administration of high-dose cytarabine and intermediate-dose cytarabine, 1265 inpatient days were saved with an approximate revenue of $3,135,176 generated in our study period. Conclusion Inpatient/outpatient administration of high-dose cytarabine and intermediate-dose cytarabine is both safe and feasible. Moving high-dose cytarabine/intermediate-dose cytarabine administration to the outpatient setting resulted in significant additional revenue vs. inpatient administration.

Safety and feasibility of outpatient high-dose cytarabine (HIDAC) and intermediate-dose cytarabine (IDAC) for consolidation therapy in acute myeloid leukemia (AML).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18509-e18509
Author(s):  
Wenhui Li ◽  
Katherine Simondsen ◽  
Jamie Lee ◽  
Maher Elharake ◽  
Timothy Edward Kubal
Keyword(s):  
Acute Myeloid Leukemia ◽  
Risk Stratification ◽  
Induction Therapy ◽  
Myeloid Leukemia ◽  
Cost Savings ◽  
Outpatient Setting ◽  
High Dose ◽  
Inpatient Setting ◽  
Consolidation Therapy ◽  
Acute Myeloid

e18509 Background: Patients with acute myeloid leukemia (AML) who achieve complete remission with induction therapy require consolidation therapy. The standard of care consolidation is HIDAC or IDAC depending on age and risk stratification. Consolidation therapy has historically been administered in the inpatient setting. The rising cost of AML care has prompted institutions to consider shifting therapy to the outpatient setting. However, the safety and feasibility of outpatient HIDAC/IDAC consolidation therapy has not been established. Moffitt Cancer Center (MCC) developed an Inpatient/Outpatient (IPOP) program to facilitate administration of complicated regimens in the outpatient setting. We hypothesized that IPOP administration of HIDAC/IDAC consolidation therapy is safe and may have cost-savings implications. Methods: We conducted a retrospective chart review on AML patients who were 18 years or older and received HIDAC/IDAC consolidation therapy at MCC following induction therapy from January 1, 2015 to November 1, 2018. Data collected included age, risk stratification, treatment history, clinic visits, number of cycles received in the IPOP versus inpatient setting, supportive care, hospitalizations, and chemotherapy related adverse events. Results: 258 of 270 cycles of HIDAC/IDAC were delivered outpatient over the reviewed time period to 122 patients. 45 patients (37%) required hospitalization during consolidation with the primary reason being neutropenic fever (72%), consistent with historical data (50 to 90%). No patients receiving outpatient consolidation required hospitalization during chemotherapy. Specific details regarding administration of HIDAC/IDAC in IPOP, including infusion times, frequency of visits, laboratory frequency, supportive medications, and home antimicrobials will be reported. 1,290 hospital days were saved through IPOP administration. Financial assessment of cost-savings is being determined and will be reported. Conclusions: Outpatient administration of HIDAC/IDAC consolidation therapy for AML is a safe option for AML patients undergoing consolidation.

scholarly journals Integrating clinical features with genetic factors enhances survival prediction for adults with acute myeloid leukemia

2020 ◽  
Vol 4 (10) ◽  
pp. 2339-2350 ◽  
Author(s):  
Douglas R. A. Silveira ◽  
Lynn Quek ◽  
Itamar S. Santos ◽  
Anna Corby ◽  
Juan L. Coelho-Silva ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Risk Stratification ◽  
Myeloid Leukemia ◽  
Sao Paulo ◽  
Survival Prediction ◽  
São Paulo ◽  
Data Set ◽  
Significant Difference ◽  
De Medicina ◽  
Acute Myeloid

Abstract The 2017 European LeukemiaNet 2017 acute myeloid leukemia (AML) risk stratification (ELN2017) is widely used for risk-stratifying patients with AML. However, its applicability in low- and middle-income countries is limited because of a lack of full cytogenetic and molecular information at diagnosis. Here, we propose an alternative for risk stratification (the Adapted Genetic Risk [AGR]), which permits cytogenetic or molecular missing data while retaining prognostic power. We first analyzed 167 intensively treated patients with nonacute promyelocytic leukemia AML enrolled in São Paulo, Brazil (Faculdade de Medicina da Universidade de São Paulo), as our training data set, using ELN2017 as the standard for comparison with our AGR. Next, we combined our AGR with clinical prognostic parameters found in a Cox proportional hazards model to create a novel scoring system (survival AML score, SAMLS) that stratifies patients with newly diagnosed AML. Finally, we have used 2 independent test cohorts, Faculdade de Medicina de Ribeirão Preto (FMRP; Brazil, n = 145) and Oxford University Hospitals (OUH; United Kingdom, n = 157) for validating our findings. AGR was statistically significant for overall survival (OS) in both test cohorts (FMRP, P = .037; OUH, P = .012) and disease-free survival in FMRP (P = .04). The clinical prognostic features in SAMLS were age (>45 years), white blood cell count (<1.5 or >30.0 × 103/μL), and low albumin levels (<3.8 g/dL), which were associated with worse OS in all 3 cohorts. SAMLS showed a significant difference in OS in the training cohort (P < .001) and test cohorts (FMRP, P = .0018; OUH, P < .001). Therefore, SAMLS, which incorporates the novel AGR evaluation with clinical parameters, is an accurate tool for AML risk assessment.

High-Dose Cytarabine Consolidation With or Without Additional Amsacrine and Mitoxantrone in Acute Myeloid Leukemia: Results of the Prospective Randomized AML2003 Trial

2013 ◽  
Vol 31 (17) ◽  
pp. 2094-2102 ◽  
Author(s):  
Markus Schaich ◽  
Stefani Parmentier ◽  
Michael Kramer ◽  
Thomas Illmer ◽  
Friedrich Stölzel ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Treatment Outcome ◽  
Myeloid Leukemia ◽  
Standard Dose ◽  
Disease Free Survival ◽  
High Dose ◽  
Hematopoietic Stem ◽  
Significant Difference ◽  
High Dose Cytarabine ◽  
Acute Myeloid

Purpose To assess the treatment outcome benefit of multiagent consolidation in young adults with acute myeloid leukemia (AML) in a prospective, randomized, multicenter trial. Patients and Methods Between December 2003 and November 2009, 1,179 patients (median age, 48 years; range, 16 to 60 years) with untreated AML were randomly assigned at diagnosis to receive either standard high-dose cytarabine consolidation with three cycles of 18 g/m2 (3× HD-AraC) or multiagent consolidation with two cycles of mitoxantrone (30 mg/m2) plus cytarabine (12 g/m2) and one cycle of amsacrine (500 mg/m2) plus cytarabine (10 g/m2; MAC/MAMAC/MAC). Allogeneic and autologous hematopoietic stem-cell transplantations were performed in a risk-adapted and priority-based manner. Results After double induction therapy using a 3 + 7 regimen including standard-dose cytarabine and daunorubicin, complete remission was achieved in 65% of patients. In the primary efficacy population of patients evaluable for consolidation outcomes, consolidation with either 3× HD-AraC or MAC/MAMC/MAC did not result in any significant difference in 3-year overall (69% v 64%; P = .18) or disease-free survival (46% v 48%; P = .99) according to the intention-to-treat analysis. Furthermore, MAC/MAMAC/MAC led to additional GI and hepatic toxicity and a higher rate of infection and bleeding, resulting in significantly shorter 3-year overall survival in the per-protocol analysis compared with 3× HD-AraC (63% v 72%; P = .04). Conclusion In younger adults with AML, multiagent consolidation using mitoxantrone and amsacrine in combination with high-dose cytarabine does not improve treatment outcome and confers additional toxicity.

International Randomized Phase III Study of Elacytarabine Versus Investigator Choice in Patients With Relapsed/Refractory Acute Myeloid Leukemia

2014 ◽  
Vol 32 (18) ◽  
pp. 1919-1926 ◽  
Author(s):  
Gail J. Roboz ◽  
Todd Rosenblat ◽  
Martha Arellano ◽  
Marco Gobbi ◽  
Jessica K. Altman ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Phase Iii ◽  
Control Treatment ◽  
High Dose ◽  
Dismal Prognosis ◽  
Significant Difference ◽  
Acute Myeloid ◽  
Refractory Aml

Purpose Most patients with acute myeloid leukemia (AML) eventually experience relapse. Relapsed/refractory AML has a dismal prognosis and currently available treatment options are generally ineffective. The objective of this large, international, randomized clinical trial was to investigate the efficacy of elacytarabine, a novel elaidic acid ester of cytarabine, versus the investigator's choice of one of seven commonly used AML salvage regimens, including high-dose cytarabine, multiagent chemotherapy, hypomethylating agents, hydroxyurea, and supportive care. Patients and Methods A total of 381 patients with relapsed/refractory AML were treated in North America, Europe, and Australia. Investigators selected a control treatment for individual patients before random assignment. The primary end point was overall survival (OS). Results There were no significant differences in OS (3.5 v 3.3 months), response rate (23% v 21%), or relapse-free survival (5.1 v 3.7 months) between the elacytarabine and control arms, respectively. There was no significant difference in OS among any of the investigator's choice regimens. Prolonged survival was only achieved in a few patients in both study arms whose disease responded and who underwent allogeneic stem-cell transplantation. Conclusion Neither elacytarabine nor any of the seven alternative treatment regimens provided clinically meaningful benefit to these patients. OS in both study arms and for all treatments was extremely poor. Novel agents, novel clinical trial designs, and novel strategies of drug development are all desperately needed for this patient population.

scholarly journals A phase 2 study of high-dose lenalidomide as initial therapy for older patients with acute myeloid leukemia

Blood ◽  
2011 ◽  
Vol 117 (6) ◽  
pp. 1828-1833 ◽  
Author(s):  
Todd A. Fehniger ◽  
Geoffrey L. Uy ◽  
Kathryn Trinkaus ◽  
Alissa D. Nelson ◽  
Jeffery Demland ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Older Patients ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Initial Therapy ◽  
Clinical Activity ◽  
High Dose ◽  
Phase 2 ◽  
Phase 2 Study ◽  
Acute Myeloid

Abstract Older patients with acute myeloid leukemia (AML) have limited treatment options and a poor prognosis, thereby warranting novel therapeutic strategies. We evaluated the efficacy of lenalidomide as front-line therapy for older AML patients. In this phase 2 study, patients 60 years of age or older with untreated AML received high-dose (HD) lenalidomide at 50 mg daily for up to 2 28-day cycles. If patients achieved a complete remission (CR)/CR with incomplete blood count recovery (CRi) or did not progress after 2 cycles of HD lenalidomide, they received low-dose lenalidomide (10 mg daily) until disease progression, an unacceptable adverse event, or completion of 12 cycles. Thirty-three AML patients (median age, 71 years) were enrolled with intermediate (55%), unfavorable (39%), or unknown (6%) cytogenetic risk. Overall CR/CRi rate was 30%, and 53% in patients completing HD lenalidomide. The CR/CRi rate was significantly higher in patients presenting with a low (< 1000/μL) circulating blast count (50%, P = .01). The median time to CR/CRi was 30 days, and duration of CR/CRi was 10 months (range, 1- ≥ 17 months). The most common grades ≥ 3 toxicities were thrombocytopenia, anemia, infection, and neutropenia. HD lenalidomide has evidence of clinical activity as initial therapy for older AML patients, and further study of lenalidomide in AML and MDS is warranted. This study is registered at www.clinicaltrials.gov as #NCT00546897.

Prior High Dose Chemotherapy and a Higher “Intensity” of the Preparative Regimen Can Influence Outcome after Reduced Intensity Conditioning (RIC) Allogeneic Stem Cell Transplantation (allo-SCT) for Acute Myeloid Leukemia (AML) in First Complete Remission (CR1).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2001-2001
Author(s):  
Mohamad Mohty ◽  
Xavier Cahu ◽  
Catherine Faucher ◽  
Patrice Chevallier ◽  
Norbert Vey ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Comprehensive Treatment ◽  
High Dose ◽  
Actual Performance ◽  
Gvhd Prophylaxis ◽  
Significant Difference ◽  
Preparative Regimen ◽  
Acute Myeloid

Abstract In the setting of AML, RIC regimens have emerged as an attractive modality to decrease toxicity. However, toxicity might represent only one aspect of the problem, since AML encompasses a group of chemosensitive diseases, raising concerns that significant reduction of the intensity of the preparative regimen, while increasing immunosuppression, may have a negative impact on long-term outcome. This report describes the comparative results of 31 AML patients in CR1 receiving RIC allo-SCT from an HLA-identical sibling in 2 institutions (Nantes, n=13; and Marseille, n=18) using 2 different “global” treatment approaches (Table below). After achievement of CR1, the “Nantes” approach included administration of one or two courses of consolidation with high-dose cytarabine (HDC), followed immediately by allo-SCT conditioned with a genuine nonmyeloablative, but highly immunosuppressive RIC regimen including fludarabine, low dose busulfan (4 mg/Kg), ATG (5 mg/Kg) and both CsA and corticosteroids for GVHD prophylaxis (“FB1A2” group). The “Marseille” program aimed to deliver after CR1, in addition to HDC, an autologous SCT followed by allo-SCT conditioned with fludarabine, an intermediate dose of busulfan (8 mg/Kg), low dose ATG (2.5 mg/Kg) and CsA alone for GVHD prophylaxis (“FB2A1” group). In the “FB2A1” group, 12 patients (67%) could actually receive the planned auto-SCT. With a median follow-up of 47 months, leukemia-free survival (LFS) in the whole study population was 56% at 5 years. However, the KM estimate of LFS was significantly higher in the “FB2A1” group as compared to the “FB1A2” group (P=0.01; 72% vs. 31% at 5 years). Overall, 8 patients (26%; 95%CI, 11–41%) had relapsed at a median of 320 (range, 241–707) days after diagnosis, and the significant difference between the 2 groups in terms of LFS was likely due to a higher risk of leukemia relapse in the “FB1A2” group (6/13, vs. 2/18; P=0.07). Five patients died from toxicity, for an overall incidence of TRM of 16% (95%CI, 6–34%), with this being comparable between the 2 groups (2/13 vs. 3/18; P=NS). Such comparable TRM despite a more “intensive” approach, translated towards a higher overall survival in the “FB2A1” group as compared to the “FB1A2” group (72% vs. 42% at 5 years; P=0.07). After controlling for relevant factors, in the multivariate analysis, actual performance of auto-SCT prior to RIC allo-SCT (P=0.04; RR=4.9; 95%CI, 1.1–22.4), was significantly predictive of an improved LFS. We conclude that RIC allo-SCT from an HLA-matched related donor represents a valid option for AML patients not eligible for standard allo-SCT. However, in order to achieve optimal results, a comprehensive treatment “package” including some form of high dose therapy prior to RIC allo-SCT and/or semi-intensive cytoreduction/myeloablation incorporated within the RIC regimen is likely necessary to allow sufficient time for the GVL effect. Table. Patients’ characteristics and acute myeloid leukemia features

Continuous High-Dose Idarubicin and Busulfan As Conditioning Regimen for Chinese Patients with Acute Myeloid Leukemia Undergoing Autologous Stem Cell Transplantation

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4539-4539
Author(s):  
Hong Ming ◽  
Sixuan Qian ◽  
Liu Peng ◽  
Wu Hanxin ◽  
Qiu Hongxia ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Complete Remission ◽  
Myeloid Leukemia ◽  
Conditioning Regimen ◽  
Chinese Patients ◽  
High Dose ◽  
Significant Difference ◽  
First Complete Remission ◽  
Acute Myeloid

Abstract Abstract 4539 Objective: To investigate the efficacy and toxicity of continuous high-dose idarubicin and busulfan as conditioning regimen for Chinese patients with acute myeloid leukemia (AML) undergoing autologous stem cell transplantation (ASCT). Methods: A total of 27 patients with AML were enrolled in our prospective study, including 25 of first complete remission and 2 of second complete remission. Twelve patients were male, and 15 were female, with ages ranging from 14 to 56 (median, 31) years. All the patients were given induction and consolidation treatments and underwent ASCT receiving a continuous infusion of high-dose idarubicin (20 mg/m2 qd, days -13 to -11) and busulfan (oral busulfan 1 mg/kg q6h or intravenous busulfan 0.8 mg/kg q6h, d-5∼-2) as conditioning regimen. Results: All the patients acquired hematopoietic reconstitution. The median number of days to neutrophil (©ƒ0.5×109/l) and platelet (©ƒ20×109/l) recovery was 10 and 12, respectively. After a median follow-up of 23 months from diagnosis, the median overall survival (OS) and the median disease-free survival (DFS) were 19(7∼87) and 15(6∼85) months, respectively. A total of 18 patients (73.4%) are alive (17 in continuous complete remission) and 10 (37.4%) relapsed after transplant. Those who underwent standard dose of idarubicin (12 mg/m2 qd, days1–3) and cytarabine (100∼200 mg/m2 qd, days1–7) as induction treatment showed lower relapse rate and better OS and DFS as compared to other induction regimens without significant difference. Patients with favorable karyotypes and molecular biological types acquired better OS and DFS as compared to those with intermediate karyotypes and molecular biological types, but there was no significant difference. Myelosuppression and infections due to neutropenia was the most frequent adverse effects, severe nonhematologic toxicity was not observed in all patients. The patients in our study acquired similar OS and DFS compared to those with intermediate karyotypes and molecular biological types who underwent allogeneic transplantation (HLA identical sibling donor) in first complete remission, and the side effects were minor. Conclusion: Continuous high-dose idarubicin and busulfan as conditioning regimen for Chinese patients with AML undergoing ASCT was effect and well tolerable. Disclosures: No relevant conflicts of interest to declare.

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