Outcomes with intensive treatment for acute myeloid leukemia: an analysis of two decades of data from the HARMONY Alliance

Since 2017, targeted therapies combined with conventional intensive chemotherapy have started to improve outcomes of patients with acute myeloid leukemia (AML). However, even before these innovations, outcomes with intensive chemotherapy had improved, which has not yet been extensively studied. Thus, we used a large pan-European multicenter dataset of the HARMONY Alliance to evaluate treatment-time dependent outcomes over two decades. In 5,359 AML patients, we compared the impact of intensive induction therapy on outcome over four consecutive 5-year calendar periods from 1997 to 2016. During that time, the 5-year survival of AML patients improved significantly, also across different genetic risk groups. In particular, the 60-day mortality rate dropped from 13.0% to 4.7% over time. The independent effect of calendar periods on outcome was confirmed in multivariate models. Improvements were documented both for patients <60 and ≥60 years old, and in those treated with and without consolidating allogeneic hematopoietic stem cell transplantation (alloHCT). While survival of AML elderly patients remains poor, patients ≥60 years old overall have a 20% survival benefit at 5 years if they receive an alloHCT. While further outcome improvement in intensively treated AML patients will likely be driven by targeted treatment approaches, this pan-European HARMONY dataset can serve as a multicenter comparator for future studies.

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Publication Details

Journal
Haematologica
Published
2024-11-07
DOI
https://doi.org/10.3324/haematol.2024.285805
Citations
5
Primary Topic
Acute Myeloid Leukemia Research
Type
article
Field-Weighted Citation Impact
2.27

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article

Outcomes with intensive treatment for acute myeloid leukemia: an analysis of two decades of data from the HARMONY Alliance

Martje Barbus, Christian Thiede, María Abáigar, Laura Tur et al.
5 citations
Haematologica
Acute Myeloid Leukemia Research
2.27
article

Outcomes with intensive treatment for acute myeloid leukemia: an analysis of two decades of data from the HARMONY Alliance

Martje Barbus, Christian Thiede, María Abáigar, Laura Tur, Alberto Hernández‐Sánchez, Eric Sträng, Jorge Sierra, Gastone Castellani, Klaus Hans Metzeler, Javier Martínez Elicegui, Brian J.P. Huntly, Axel Benner, Joaquín Martínez‐López, Jesús María Hernández‐Rivas, Marta Sobas, Daniele Dall’Olio, Lars Bullinger, Torsten Haferlach, Jesse M. Tettero, Frédérik Damm, Renate Schulze‐Rath, Konstanze Döhner, Amin T. Turki, Rubén Villoria Medina, Raúl Azibeiro Melchor, Sören Lehmann, Ángela Villaverde Ramiro, Ken Mills, Dirk Reinhardt, Rosa María Ayala, Hartmut Döhner, Matteo Giovanni Della Porta, Teresa González, Gert Jan Ossenkoppele, Jiří Mayer
article en
5 citations

Abstract

Since 2017, targeted therapies combined with conventional intensive chemotherapy have started to improve outcomes of patients with acute myeloid leukemia (AML). However, even before these innovations, outcomes with intensive chemotherapy had improved, which has not yet been extensively studied. Thus, we used a large pan-European multicenter dataset of the HARMONY Alliance to evaluate treatment-time dependent outcomes over two decades. In 5,359 AML patients, we compared the impact of intensive induction therapy on outcome over four consecutive 5-year calendar periods from 1997 to 2016. During that time, the 5-year survival of AML patients improved significantly, also across different genetic risk groups. In particular, the 60-day mortality rate dropped from 13.0% to 4.7% over time. The independent effect of calendar periods on outcome was confirmed in multivariate models. Improvements were documented both for patients <60 and ≥60 years old, and in those treated with and without consolidating allogeneic hematopoietic stem cell transplantation (alloHCT). While survival of AML elderly patients remains poor, patients ≥60 years old overall have a 20% survival benefit at 5 years if they receive an alloHCT. While further outcome improvement in intensively treated AML patients will likely be driven by targeted treatment approaches, this pan-European HARMONY dataset can serve as a multicenter comparator for future studies.

HaematologicaVol. 110(5)
Queen's University Belfast (GB), Humanitas University (IT), Uppsala University Hospital (SE), German Cancer Research Center (DE), Universidad de Salamanca (ES), Wellcome/MRC Cambridge Stem Cell Institute (GB), Masaryk University (CZ), Heidelberg University (DE), University of Cambridge (GB), University Hospitals of the Ruhr-University of Bochum (DE), Hospital de Sant Pau (ES), Wroclaw Medical University (PL), Humboldt-Universität zu Berlin (DE), Munich Leukemia Laboratory (Germany) (DE), Hospital Universitario 12 De Octubre (ES), University Hospital Brno (CZ), German Cancer Society (DE), Istituto delle Scienze Neurologiche di Bologna (IT), AbbVie (Germany) (DE), Instituto de Investigación Biomédica de Salamanca (ES), Stem Cell Institute (PA), Centro de Investigación del Cáncer (ES), Amsterdam University Medical Centers (NL), Istituti di Ricovero e Cura a Carattere Scientifico (IT), University Hospital Ulm (DE), IRCCS Humanitas Research Hospital (IT), University of Duisburg-Essen (DE), Bayer (Germany) (DE), Freie Universität Berlin (DE), Technische Universität Dresden (DE), Charité - Universitätsmedizin Berlin (DE), GMV Innovating Solutions (Spain) (ES), Vrije Universiteit Amsterdam (NL), Ruhr University Bochum (DE), Leipzig University (DE), University of Bologna (IT)
Amgen, Bristol-Myers Squibb, Pfizer, AstraZeneca, Gilead Sciences, Celgene, Jazz Pharmaceuticals, European Federation of Pharmaceutical Industries and Associations, Agios Pharmaceuticals, Incyte, European Commission, Deutsche Forschungsgemeinschaft, Astellas Pharma, Servier, Medical Research Council, Daiichi Sankyo Europe
Good health and well-being
Openalex Percentile: Top 11%
Acute Myeloid Leukemia Research
2.27
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