Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy

Acute myeloid leukemia (AML) is mainly a disease of the elderly: however, knowledge about the outcomes of treatment of core-binding factor (CBF) AML in an older population is limited. We retrospectively collected data on 229 patients with CBF-AML followed long-term in the last two decades. The 5-year overall survival was 44.2% (95% confidence interval [95% CI]: 39.9-47.5) and the 5-year event-free survival was 32.9% (95% CI: 25.5-40.1). In a subgroup of patients ≥70 years old who completed intensive therapy (induction + ≥3 courses of consolidation including autologous stem cell transplantation: 10 patients) the median event-free survival was 11.8 months (95% CI: 9.4-15.2) and overall survival was 40.0% (95% CI: 36.4- 44.1) at 5 years. In univariate analysis, age ≥70 years (hazard ratio [HR]=1.78, 95% CI: 1.15-2.54, P=0.008), failure to achieve remission following induction (HR=8.96, 95% CI: 5.5-13.8; P<0.0001), no consolidation therapy (HR=0.75, 95% CI: 0.47-1.84, P=0.04) and fewer than three cycles of consolidation (HR=1.48, 95% CI: 0.75-3.2; P=0.0004) predicted poorer event-free survival. Our study shows that intensive therapy, in selected older CBF-AML patients, leads to longer survival. Achieving a complete remission seems to be the most important first step and at least three cycles of consolidation, an important second one. The analysis suggests that these patients should not be excluded from studies with intensive therapies.

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Publication Details

Journal
Haematologica
Published
2024-10-10
DOI
https://doi.org/10.3324/haematol.2024.285448
Citations
3
Primary Topic
Acute Myeloid Leukemia Research
Type
article
Field-Weighted Citation Impact
1.36

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article

Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy

Fabio Forghieri, Sara Galimberti, Nicolaus Martin Kröger, Anna Candoni et al.
3 citations
Haematologica
Acute Myeloid Leukemia Research
1.36
article

Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy

Fabio Forghieri, Sara Galimberti, Nicolaus Martin Kröger, Anna Candoni, Peter Valent, H. Joachim Deeg, Moreno Festuccia, Federico Mosna, Elizabeth A. Morgan, Michele Gottardi, Alessandra Sperotto, Roberto Cairoli, Mauro Krampera, Erika Borlenghi, Giuseppe Visani, Sheeja T. Pullarkat, Gerwin Huls, Gian Matteo Rigolin, Felicetto Ferrara, Carmela Gurrieri, Eros DiBona, Cristina Papayannidis, Monia Lunghi, Gautam M. Borthakur, Guido Marcucci, Debora Capelli, Cecilia C.S. Yeung, Jason Gotlib, Giovanni Roti, Cristina Tecchio, Francesco Albano, Giovanni Martinelli, Ann‐Kathrin Eisfeld, Ernesta Audisio, Mark R. Litzow, Denise Marvalle, Adriano Venditti, John C. Byrd, Francesco Lanza
article en
3 citations

Abstract

Acute myeloid leukemia (AML) is mainly a disease of the elderly: however, knowledge about the outcomes of treatment of core-binding factor (CBF) AML in an older population is limited. We retrospectively collected data on 229 patients with CBF-AML followed long-term in the last two decades. The 5-year overall survival was 44.2% (95% confidence interval [95% CI]: 39.9-47.5) and the 5-year event-free survival was 32.9% (95% CI: 25.5-40.1). In a subgroup of patients ≥70 years old who completed intensive therapy (induction + ≥3 courses of consolidation including autologous stem cell transplantation: 10 patients) the median event-free survival was 11.8 months (95% CI: 9.4-15.2) and overall survival was 40.0% (95% CI: 36.4- 44.1) at 5 years. In univariate analysis, age ≥70 years (hazard ratio [HR]=1.78, 95% CI: 1.15-2.54, P=0.008), failure to achieve remission following induction (HR=8.96, 95% CI: 5.5-13.8; P<0.0001), no consolidation therapy (HR=0.75, 95% CI: 0.47-1.84, P=0.04) and fewer than three cycles of consolidation (HR=1.48, 95% CI: 0.75-3.2; P=0.0004) predicted poorer event-free survival. Our study shows that intensive therapy, in selected older CBF-AML patients, leads to longer survival. Achieving a complete remission seems to be the most important first step and at least three cycles of consolidation, an important second one. The analysis suggests that these patients should not be excluded from studies with intensive therapies.

HaematologicaVol. 110(3)
University of Pisa (IT), University of Rome Tor Vergata (IT), University of Verona (IT), Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT), Brigham and Women's Hospital (US), Mayo Clinic (US), The University of Texas MD Anderson Cancer Center (US), Harvard University (US), Universität Hamburg (DE), University of California, Los Angeles (US), University of Groningen (NL), Paracelsus Medical University (AT), Azienda Ospedaliera Citta' della Salute e della Scienza di Torino (IT), Ospedale Maggiore (IT), Ospedale Antonio Cardarelli (IT), Fred Hutch Cancer Center (US), Ospedale di Bolzano (IT), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IT), Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT), Ospedali Riuniti di Ancona (IT), University Medical Center Hamburg-Eppendorf (DE), Azienda Ospedaliero Universitaria Ospedali Riuniti (IT), Azienda Ospedaliero-Universitaria di Modena (IT), Istituto Oncologico Veneto (IT), City of Hope (US), Istituto di Ematologia di Bologna (IT), Azienda Ospedaliero Universitaria Maggiore della Carita (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Arcispedale Sant'Anna (IT), Azienda USL della Valle d’Aosta (IT), Stanford Blood Center (US), Ospedale di Parma (IT), Azienda Ospedale - Università Padova (IT), Ospedale San Bortolo (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), University of Turin (IT), University of Bari Aldo Moro (IT), University of Cincinnati (US), Medical University of Vienna (AT), University of Bologna (IT)
National Institutes of Health, National Cancer Institute
No poverty
Openalex Percentile: Top 17%
Acute Myeloid Leukemia Research
1.36
DOIOpen Access PDFOpenAlex
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