No abstract

Summary Following the 2017 European LeukemiaNet (ELN) guidelines, we changed our practice from using high‐dose cytarabine (HIDAC‐3 g/m2 q12h‐D1,3,5) to intermediate‐dose cytarabine (IDAC‐1·5 g/m2 q12h‐D1,3,5/D1–3) for consolidation in young(<60 years) favourable‐risk acute myeloid leukaemia (AML) patients. We assessed the clinical impact of this practice change. Of 80 patients, 51 received HIDAC prior to the protocol change, and subsequently, 29 received IDAC. The three‐year risk of relapse was significantly higher with IDAC [61%; 95% confidence interval (CI) 40–82] compared with HIDAC (22%; 10–34), P < 0·01. Our findings suggest HIDAC, rather than IDAC, is the preferred dose for single‐agent cytarabine consolidation in young, favourable‐risk AML following 7+3 induction.

The prognostic value of measurable residual disease (MRD) by flow cytometry in acute myeloid leukemia (AML) patients treated with non-intensive therapy is relatively unexplored. The clinical value of MRD threshold below 0.1% is also unknown after non-intensive therapy. In this study, MRD to a sensitivity of 0.01% was analyzed in sixty-three patients in remission after azacitidine/venetoclax treatment. Multivariable cox regression analysis identified prognostic factors associated with cumulative incidence of relapse (CIR), progression-free survival (PFS) and overall survival (OS). Patients who achieved MRD < 0.1% had a lower relapse rate than those who were MRD ≥ 0.1% at 18 months (13% versus 57%, p = 0.006). Patients who achieved an MRD-negative CR had longer median PFS and OS (not reached and 26.5 months) than those who were MRD-positive (12.6 and 10.3 months, respectively). MRD < 0.1% was an independent predictor for CIR, PFS, and OS, after adjusting for European Leukemia Net (ELN) risk, complex karyotype, and transplant (HR 5.92, 95% CI 1.34-26.09, p = 0.019 for PFS; HR 2.60, 95% CI 1.02-6.63, p = 0.046 for OS). Only an MRD threshold of 0.1%, and not 0.01%, was predictive for OS. Our results validate the recommended ELN MRD cut-off of 0.1% to discriminate between patients with improved CIR, PFS, and OS after azacitidine/venetoclax therapy.

No abstract

Vino-Cy is a potential alternative to Cy given the need for effective mobilisation protocols with acceptable toxicity.