scholarly journals Screening Chest CT Prior to Allogenic Transplantation - High Rates of Occult Abnormalities

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1777-1777
Author(s):  
Mohammad Alhomoud ◽  
Alexandra Gomez-Arteaga ◽  
Sebastian A. Mayer ◽  
Jingmei Hsu ◽  
Adrienne A. Phillips ◽  
...  
Keyword(s):  
New York ◽  
Conflicts Of Interest ◽  
Pulmonary Nodules ◽  
Pulmonary Complications ◽  
Chest Ct ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Incidental Pulmonary Embolism ◽  
Metastatic Lung ◽  
Transplant Evaluation

Abstract Introduction: Pulmonary complications constitute a major cause of morbidity and mortality in the post-hematopoietic cell transplant (HCT) period. While Chest X-ray (CXR) is customarily used for screening, we have utilized chest computed tomography (CT) within one month of transplant. Here we aim to characterize the prevalence of abnormalities and their impact on the eligibility for allogenic (allo) HCT and outcomes post-transplant. Methodology: We conducted a single center retrospective study of all patients who were evaluated for allogenic HCT from January 2013 through December 2020 in New York Presbyterian Hospital - Weill Cornell Medicine (NYP-WCM). All patients who had chest CT as part of their pre-transplant evaluation were included for analysis. Results: We identified 478 patients who had Chest CT screening. In 396 CT chest was normal or confirmed previous abnormalities. Eighty-two patients (17%) had previously undetected abnormalities (Figure 1). The most frequent abnormalities were pulmonary nodules (defined as nodules of 4 mm or greater) in 27 patients (31%), ground-glass opacities (GGO) in 21 patients (25%), Pneumonia in 18 patients (21%). Miscellaneous findings not related to the primary disease were found in 12 patients (14%) including thyroid nodules, breast nodules and hemangioma of the liver. A new malignancy was found in 6 patients (7%) and incidental pulmonary embolism (PE) in 2 patients (2%) (Figure 2). There were 5 (6%) patients who were ultimately excluded from transplant due to CT chest findings (simultaneous CXR showed abnormalities in only 1 out of 5). Three of those patients were found to have invasive fungal infection, and the other two had unrecognized metastatic lung cancer. For 19 patients (23%), transplant was delayed for diagnostic procedure and/or treatment of pulmonary findings (CXR showed abnormalities in only 3 patients out of 19). The most common reason for delay was lung infection requiring treatment. Thirty-two patients (41%) out of 77 patients with abnormal CT scan who eventually underwent transplant, have died . Sixteen died after relapse, and 16 from non-relapse mortality (NRM) with pulmonary complications playing a role in 13 patients (Figure 3). Conclusion: 17% of patients who had a pre-transplant CT chest had abnormalities that warranted further evaluation. In 23% of these patients, these findings led to a delay in transplant for further optimization. Six percent were deemed ineligible for transplant due to absolute contraindications that were incidentally discovered on chest CT. Initial screening CXR failed to identify a significant number of abnormalities. Our data suggests that chest CT imaging should be part of the routine pre-transplant evaluation. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Barriers to Reduced-Intensity Conditioning (RIC) Transplant in Patients with Chronic Lymphocytic Leukemia.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1374-1374
Author(s):  
Samantha M. Jaglowski ◽  
Thomas S. Lin ◽  
Patrick Elder ◽  
Diane Scholl ◽  
John C. Byrd ◽  
...  
Keyword(s):  
Stem Cell ◽  
Conflicts Of Interest ◽  
Therapeutic Option ◽  
Lymphocytic Leukemia ◽  
Standards Of Care ◽  
Cell Transplant ◽  
Reduced Intensity Conditioning ◽  
Current Standard ◽  
Transplant Evaluation ◽  
Reduced Intensity

Abstract Abstract 1374 Poster Board I-396 Introduction: Allogeneic stem cell transplantation is the only potentially curative therapeutic option for patients with CLL. However, in spite of recent improvements in transplant-related mortality due to the introduction of reduced-intensity conditioning (RIC), only a proportion of patients go on to receive a stem cell transplant. The aim of this study was to quantify how many patients are evaluated for transplant versus how many go on to transplant, and to examine the reasons why transplantation was not performed. Patients and methods: A list of all patients with CLL who have been referred to the Ohio State University for a transplant evaluation from January 2003 to the present was obtained. Two electronic databases, E-Results and TransChart, were reviewed to determine if a consultation was performed, if patients were subsequently transplanted, and if not, why. Results: The outcomes of the referrals are summarized in Table 1. From January 2003 to the present, 205 patients with CLL were referred to our center for a transplant evaluation. Of those, 34 (16.6%) underwent transplantation. For patients who did not receive a transplant, it was not indicated at the time of consult according to current standard of care in 37 patients (18%), and in 29 (14.1%), transplant was indicated but patients were unable to obtain a remission in order to proceed. The differences between patients who went on to transplant and those who could not obtain remission were analyzed more closely. The median age in the transplant group was 55, and the median age in the group that could not obtain remission was 58. Both groups received a median 2 lines of treatment prior to transplant evaluation. The cytogenetic abnormalities of the groups are summarized in Table 2. Conclusions: The majority of patients who did not undergo transplantation did not have an indication for transplant, reflecting previous standards of care prior to the understanding of the poor prognosis of patients with high risk karyotype and fludarabine-refractory CLL. In contradistinction, an inability to obtain a remission in order to proceed to transplantation was the second most common reason transplantation was deferred. These data reflect the difficulty in some cases of determining the appropriate timing for allogeneic transplantation in CLL and the risk of delaying a transplant referral in patients with fludarabine refractory disease. Appropriate timing of transplant referral and choice of effective salvage therapy are critical to the successful long-term management of patients with fludarabine-refractory CLL. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Isavuconazonium Sulfate Use in Multi-Modal Management of Invasive Zygomycosis in Four Pediatric Allogeneic Hematopoietic Cell Transplant Patients

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 27-27
Author(s):  
Asmaa Ferdjallah ◽  
Kristina M Nelson ◽  
Kailey Meyer ◽  
Cathryn A Jennissen ◽  
Christen L. Ebens
Keyword(s):  
Pediatric Patients ◽  
Hematopoietic Cell Transplantation ◽  
Conflicts Of Interest ◽  
Safety Data ◽  
Drug Level ◽  
Hematopoietic Cell ◽  
Cell Transplant ◽  
Loading Dose ◽  
Duration Of Treatment ◽  
Hematopoietic Cell Transplant

Prolonged neutropenia increases risk for lethal invasive fungal infection (IFI) such as Rhizopus. Isavuconazonium sulfate is a new triazole that lacks pediatric dosing recommendations. Clinical courses of 4 pediatric patients with IFI in the peri-allogeneic hematopoietic cell transplantation (alloHCT) period between 2015 and 2017 were reviewed, including previously unreported pharmacokinetic and safety data. IFI included Rhizopus and presumed fungal meningitis. Isavuconazonium sulfate was initiated with a loading dose followed by daily dosing, adjusted to a goal trough >3 ug/mL based on adult literature. This target was achieved at a median of 7 days, demonstrating varying rates of metabolism. Renal insufficiency, electrolyte disturbances, and transaminitis were noted, though attribution was confounded by other alloHCT complications. 1 patient survived infection-free to hospital discharge and 1 of 3 deceased patients had evidence of unresolved IFI (Case 2). Case 2 was subtherapeutic for 39% of the duration of treatment, compared to others at an average of 29%, suggesting this target trough to be clinically relevant. We recommend initiation of isavuconazonium sulfate at 10 mg/kg with a max dose of 372 mg. A loading dose of 10 mg/kg is utilized every 8 hours for 6 doses followed by 10 mg/kg dosing every 24 hours. Monitoring must continue beyond steady state. If early monitoring is not possible, we recommend a first drug level at week 3. If dose increases are required, a partial reload has been more successful instead of increasing daily doses. Further larger studies are needed to demonstrate optimum dosing in pediatric patients. Figure 1 Disclosures No relevant conflicts of interest to declare.

scholarly journals Donor Lymphocyte Infusions for Haematological Malignancy Relapse

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5775-5775
Author(s):  
Guillermo Orti ◽  
Irene García-Cadenas ◽  
Isabel Sánchez-Ortega ◽  
Mª Jose Jimenez ◽  
Laura Alonso ◽  
...  
Keyword(s):  
Total Dose ◽  
Conflicts Of Interest ◽  
Chronic Gvhd ◽  
Conditioning Regimen ◽  
Disease Diagnosis ◽  
Time Interval ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Allogeneic Hematopoietic Cell Transplant ◽  
Donor Lymphocyte Infusions

Abstract Donor lymphocyte infusions (DLI) are a therapeutic approach broadly used in relapse post Allogeneic Hematopoietic Cell Transplant (Allo-HCT). In CML relapse, DLI have proven very effective, but in other hematological malignancies its effectiveness has been reported rather erratic and poor; hence the need of a better understanding of factors influencing outcomes. Questions regarding the CD3 dose, the use of G-CSF mobilized DLI or the potential toxicity associated to the use of DLI from mismatched donors remain open. We report a cohort of 66 patients who, within a cell therapy program (Banc de Sang i Teixits, Barcelona), consecutively underwent allo-HCT and received DLI for relapse. Disease diagnosis was as follows: Lymphoproliferative malignancy (LPD) 29 patients AML and high-risk MDS 24 patients and ALL 13 patients (CML patients were not included). Median age at allo-HCT was 48 years (5-68). The combination female-donor and male-patient was 21%. 27% allo-HCT were T-cell depleted and 29% received a myeloablative conditioning regimen. Immunosupression was CsA-based in 83% of the allo-HCT. Transplants from HLA fully match donors were 54 (81%) and 19% were from mismatch donors. Indication for DLI was morphological relapse in 61 patients (92%) and disease detected by flow cytometer or at a molecular level in 5 patients (8%). 32 (48%) DLI were obtained at stem cell collection day (G-CSF mobilized) and cryopreserved, whereas 34 (52%) DLI were obtained by lymphapheresis. The median follow-up was 198 days (9-4246). The estimated 1-year OS was 60%. A total of 100 DLI were infused, with a median of 1.5 DLI/patient and a median time from allo-HCT to DLI of 303 days (70-5153). Median CD3+ total dose was 2x107 CD3+/Kg (first DLI median dose was 1x107 CD3+/Kg). The time interval from allo-HCT to DLI ≥10 months (Log-Rank 3.64, p=0.056) was associated to better survival. In line with this, there was a trend in patients relapsing ≥ 9 months post allo-HCT (median relapse date) for better survival (Log-Rank 3.33, p=0.068). Twenty-six patients (42%) developed GvHD post-DLI. In 17 patients overall grade was 2-4, which was not associated to poorer outcome. Lately, 8 patients developed extensive chronic GvHD. The development of chronic GvHD was associated to a better survival (Log-Rank 6.07, p=0.014). A total dose ≥1x107CD3+/Kg was associated to a better survival (Log-Rank 4.78, p=0.029) compared to total lower doses. The achievement of complete remission post DLI was also associated to better OS (Log-Rank 4.54, p=0.33). Ten patients died due to non-relapse mortality causes and twenty-seven due to disease progression. Of interest, we found a trend on outcomes when using non G-CSF mobilized DLI compared to-G-GCF mobilized DLI (Log-Rank 2.65, p= 0.104). However, the administration of a pre DLI debulky therapy was not associated with better outcomes. Variables with p<0.1 were included in the multivariate analysis, which identified the achievement of CR post DLI (p=025), chronic GvHD (p=0.026), total dose ≥1x107CD3+/Kg (p=0.026) and time from allo-HCT to DLI ≥10 months (p=0.026) associated to a better OS. Overall, this study reports a poor prognostic cohort, in which the vast majority had a post allo-HCT morphological relapse. In this group, patients treated with DLI can have a prolonged survival by achieving CR. Additionally, the survival appeared to be DLI dose-dependent, since patients receiving doses ≥1x107CD3+/Kg had better OS. Additionally, the development of chronic GvHD was associated to a better OS. Fig 1. OS according to the total CD3 dose infused Fig 2. OS according to the development of chronic GvHD Fig 3. OS according to the response post DLI. Disclosures No relevant conflicts of interest to declare.

Incidence of Cytomegalovirus (CMV) Reactivation after Autologous Peripheral Blood Stem Cell Transplantation (ASCT) in 324 Patients with Multiple Myeloma and Lymphoma: A Single-Center Study at the American University of Beirut Medical Center (AUBMC)

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5824-5824
Author(s):  
Radwan Massoud ◽  
Rita Assi ◽  
Elie Fares ◽  
Nabila Kreidieh ◽  
Rami Mahfouz ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Medical Center ◽  
Quantitative Polymerase Chain Reaction ◽  
Cell Transplant ◽  
Single Center ◽  
Hematopoietic Cell Transplant ◽  
Single Center Study ◽  
Significant Difference ◽  
Cmv Reactivation ◽  
Center Study

Abstract CONTEXT: Cytomegalovirus reactivation (R-CMV) is often diagnosed in allogeneic hematopoietic cell transplant recipients and could determine a CMV-related disease in these immunocompromised patients, involving any organ. R-CMV and end-organ disease after ASCT has not been studied thoroughly. Autograft recipients are generally considered to have low risk of R-CMV or end-organ disease. OBJECTIVE: Evaluate the incidence, risk factors, and outcome of R-CMV in adult patients with hematologic malignancies undergoing ASCT. DESIGN: Retrospective single center study. SETTING: This study was approved by the institutional review board of AUBMC and conducted at our institution PATIENTS OR OTHER PARTICIPANTS: A total of 324 consecutive ASCT were performed at AUBMC between January 2005 and March 2016. All patients and transplant-related characteristics are listed on Table 1. CMV DNA load in blood was measured by quantitative polymerase chain reaction (PCR) weekly as a routine monitoring strategy in all patients. Irrespective of PCR results, some patients suspected to have gastrointestinal involvement were biopsied. Also, in the presence of symptomatic CMV reactivation, appropriate anti-CMV therapy was instituted. MAIN OUTCOMES MEASURES: The primary outcome is understanding the potential relationship between R-CMV and Overall Survival (OS). Secondary outcomes included the effect of CMV reactivation on transplant related mortality (TRM), and progression free survival (PFS). RESULTS: Overall, 53 (16%) patients had R-CMV and 38 (72%) required anti-CMV treatment. Five (1,5%) had CMV disease with positive PCR on colon biopsy, yet two had PCR negative in blood. After a median follow up of 21.5 months (range: 1 to 125 months), there was no significant difference in OS or PFS between patients with or without R-CMV. TRM has increased from 1.1% in patients with no R-CMV to 13% in patients with R-CMV (P=0.003). We didn't observe any impact for age, sex, type of disease, pre-transplant treatment types/lines on the incidence R-CMV following ASCT. CONCLUSIONS: Our data suggest that R-CMV is not uncommon in ASCT recipients and may contribute to increased TRM. Biopsy is recommended in case of high suspicion of R-CMV irrespective of PCR results. Disclosures No relevant conflicts of interest to declare.

scholarly journals Response Kinetics of Daratumumab-Based Regimens in Patients with Newly Diagnosed or Refractory/Relapsed Multiple Myeloma

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3806-3806
Author(s):  
Jiasheng Wang ◽  
Raul Arroyo-Suarez ◽  
William Tse
Keyword(s):  
Multiple Myeloma ◽  
Clinical Outcomes ◽  
Median Time ◽  
Conflicts Of Interest ◽  
Residual Disease ◽  
Late Response ◽  
Cell Transplant ◽  
Newly Diagnosed ◽  
Hematopoietic Cell Transplant ◽  
Significant Difference

Abstract Background: It is controversial in multiple myeloma (MM) whether early and late responders to therapies have similar clinical outcomes. Daratumumab (DARA) is a human anti-CD38 antibody that has been increasingly used in newly diagnosed MM (NDMM) and relapsed/refractory MM (RRMM). The association between response kinetics to DARA and clinical outcomes remains unexplored. Methods: Individual-participant data were obtained from phase 3 trials: POLLUX (Dimopoulos, NEJM, 2016), CASTOR (Palumbo, NEJM, 2016), and MAIA (Facon, NEJM, 2019). Patients were divided into early and late response groups based on the median time to the response of interest. Modified PFS (mPFS) and OS (mOS) were calculated from the time of first response of interest. Minimal residual disease (MRD) negativity was defined as less than 10 5 tumor cells by NGS assays. Results: After a median follow up of 16.1 months, 670 patients achieved a response of very good partial response (VGPR) or better, and 213 achieved MRD negativity. The median time to achieving VGPR or better was similar between NDMM and RRMM (86 vs. 84 days, respectively), while the median time to MRD negativity was longer among NDMM than RRMM (407 vs. 197 days, respectively). Among patients achieving VGPR or better, there was no significant difference of mPFS (HR 1.00, 95%CI 0.69 to 1.44) (fig. a), duration of response (DOR) (HR 1.02, 95%CI 0.68 to 1.53) (fig. b), or mOS (HR 0.98, 95%CI 0.54 to 1.75) (fig. c) between early and late responders. In the subgroup analysis, no significant difference of DOR was observed across all prespecified groups, including sex, age, cytogenetic risk groups, lines of previous therapy, types of measurable disease, NDMM vs. RRMM, prior treatment with autologous hematopoietic cell transplant, immunomodulatory drugs, or proteasome inhibitors. Among patients with NDMM achieving MRD negativity, there was no significant difference of mPFS (p=0.66) (fig. d), DOR (p=0.21) (fig. e) or mOS (p=0.87) (fig. f) between early and late responders. However, among patients with RRMM achieving MRD negativity, late responders had significantly longer mPFS (p=0.038) (fig. g) and DOR (p=0.043) (fig. h) than early responders; mOS was not significantly different (fig. i). In the multivariable Cox analysis among patients achieving MRD negativity, only lower baseline LDH level, NDMM, and IgG type MM were independently associated with later response. Conclusions: For patients with NDMM or RRMM achieving VGPR or better, early and late responders had similar survival; for patients with RRMM achieving MRD negativity, late responders had significantly longer mPFS and DOR. Our data support that in patients who failed to achieve an early or deep response to daratumumab based regimens, therapies should be continued with the goal of achieving ongoing and stepwise improvement of response. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

Older Patients with AML Undergoing Matched Related Allogeneic Transplantation Have Significantly Older Donors but Equivalent Survival as Patients Receiving Unrelated Donor Transplants

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2356-2356
Author(s):  
Brian T. Hill ◽  
Lisa Rybicki ◽  
Brian J. Bolwell ◽  
Robert Dean ◽  
Brad Pohlman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Older Patients ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Cleveland Clinic ◽  
Unrelated Donor ◽  
Cell Transplant ◽  
Donor Age ◽  
Hematopoietic Cell Transplant ◽  
Unrelated Donors

Abstract Abstract 2356 Introduction: Allogeneic stem cell transplantation (SCT) is commonly offered to patients with acute myeloid leukemia (AML) over the age of 55 with good performance status. For this patient population, potential sibling donors are necessarily older and have more comorbidities than siblings of younger patients. It is not known whether the advanced donor age of older patients outweighs the beneficial effect of having a sibling donor. To address this question, we retrospectively analyzed data from 62 consecutive patients who received allogeneic SCT at the Cleveland Clinic from 1990–2009. Methods: Inclusion criteria were: age ≥ 55 years, diagnosis of AML, and history of myeloablative or nonmyeloablative allogeneic SCT from related or unrelated adult donors. 31 patients underwent transplantation from matched related donors (30 siblings, 1 cousin). 31 patients received unrelated donor transplants. The median age was 59 for patients with related and unrelated donors (P=0.89). There was an equal percentage of males (64.5%) in both groups (P=1.0). There was an equivalent distribution hematopoietic cell transplant comorbidity index scores of low, intermediate and high for patients with related and unrelated donors (38.7%, 37.1% and 24.2% vs. 38.7%, 32.3%, and 29.0% P = 0.65). 45.2% of patients with related donors underwent myeloablative conditioning vs. 54.8% for patients with unrelated donors (P =0.61). Results: Sibling donors were significantly older than unrelated donors [median 59 years (range 41–75) vs. 36 (range 24–58), P < 0.001]. The incidence of acute and chronic graft-versus-host disease (GVHD) was similar in both groups. At five years, the cumulative incidence of relapse (43.2% vs. 38.7%, P = 0.88), non-relapse mortality (48.1% vs. 48.8%, P =0.91) and overall survival (17.2% vs. 24.1%, P =0.88) were similar for recipients of matched related and unrelated donor transplants. Older donor age was not predictive of death in univariate or multivariate analysis. Kaplan-Meier estimates of overall survival for recipients of related and unrelated donor transplants are shown. Conclusion: Patients with AML 55 years or older who underwent related donor transplantation had significantly older donors but equivalent survival when compared to patient who underwent unrelated donor transplantation. Advanced donor age should not be a contraindication to allogeneic SCT for older patients with AML. Disclosures: No relevant conflicts of interest to declare.

Reinduction Chemotherapy for AML: Comparison Between CECA, High Dose Cytarabine and CLAG-M

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4301-4301
Author(s):  
Christina Escobar ◽  
Sukanthini Subbiah ◽  
Maxim Norkin ◽  
Helen Leather ◽  
Ashley Richards ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Day Treatment ◽  
Risk Groups ◽  
High Dose ◽  
Cell Transplant ◽  
Hematopoietic Cell Transplant ◽  
Allogeneic Hematopoietic Cell Transplant ◽  
Number Of Patients ◽  
The Mean

Abstract Abstract 4301 Background: Currently, there is no standard reinduction regimen for relapsed and refractory (RR) AML. In order to evaluate responses to reinduction regimens we present a retrospective side-by-side comparison frequently used AML salvage regimens at our institution: CECA, HiDAC and CLAG-M. Method: From April 2007 to May 2011, 74 consecutive patients with RR AML received CECA (n=44), HiDAC (n=18) or CLAG-M (n=12). The primary outcome was complete remission (CR) rates and secondary outcomes were overall survival (OS) and relapse free survival (RFS). Additional variables such as toxicity and transplant data were also examined. Result: Baseline characteristics among the three groups were similar except for relapse status, with a greater proportion of AML patients receiving CECA after first relapse and HiDAC and CLAG-M after multiple relapses (Table 1). The mean age was 55.6 (range, 24–70), 53.8 (range, 25–71) and 49.5 (range, 23–68) years for CECA, HiDAC and CLAG-M respectively (P=0.38). For CECA, HiDAC and CLAG-M, respectively, 29.5%, 27.7% and 50% of patients were classified with therapy-related AML (P=0.85) and 11.4%, 11.1% and 16.7% of patients were classified with AML transformed from MDS (P=0.62). There was no difference in cytogenetic risk groups between the cohorts with the majority of the patients classified as intermediate risk. The mean blast percentage at the start of treatment was equivalent between the three groups at 39.8%, 27.4% and 26.7% for CECA, HiDAC and CLAG-M respectively (P=0.25). Median follow-up for all patients was 3.5 months. CR rates for CECA, HiDAC and CLAG-M were similar (20.5%, 16.7%, 41.7%; P=0.44). Median OS was 5 months for patients receiving CECA, 5 months for HiDAC and 3.5 months for CLAG-M (P=0.91) (Figure 1A). RFS was also similar among the three groups (p=0.91) (Fig. 1B). Of patients treated with CECA, HiDAC and CLAG-M, 27.2%, 38.8% and 41.6% proceeded to allogeneic hematopoietic cell transplant (P=0.71). Of the 8 patients who achieved CR with CECA but did not proceed to transplant, 5 patients had a CR of less then 3 months, 1 refused further care, 1 was lost to follow up and 1 received further consolidation therapy then relapsed. The mean length of stay in the hospital was 33.6±3.4, 99.7±60.3 and 45.4 ±35.7 days respectively for CECA, HiDAC and CLAG-M (P=0.19). The 30-day treatment related mortality rate was 2.3%, 16.7% and 16.7% respectively (P=0.13). Patients who received CECA had a higher number of total adverse events than patients who received HiDAC and CLAG-M (Table 1), with higher rates of pulmonary edema, sepsis, fungal pneumonia and C. difficle colitis. However, due to the small number of patients per cohort, only descriptive statistics are reported. Conclusion: CECA, HiDAC and CLAG-M are equivalent AML salvage regimens in terms of CR, OS, and RFS. Although each resulted in different adverse event profiles. These data provide a basis for designing prospective clinical studies and sample size estimates to formally compare three common reinduction regimens in RR AML. Disclosures: No relevant conflicts of interest to declare.

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