Therapeutic outcomes of patients with acute erythroid leukemia treated with hypomethylating agents

Acute erythroid leukemia treatment is associated with poor survival. The most common treatments are intensive chemotherapy regimens and hypomethylating agents. Choice of preferred therapy is complex, and data are conflicting on the optimal regimen. The definition of AEL has also shifted with time but the impacts of these changes on survival reporting are largely unknown.We designed a single-center, retrospective review of patients meeting the 2001 World Health Organization definition of acute erythroid leukemia. Patients were treated with an intensive chemotherapy or a hypomethylating agent regimen. The primary outcome was overall survival.Most patients were older with complex karyotypes. Median overall survival did not differ between treatment groups. When survival was stratified by WHO 2022 diagnosis, patients meeting MDS criteria had notably increased survival outcomes while patients still meeting the definition of AEL did poorly regardless of induction regimen.Treatment of acute erythroid leukemia remains complex with poor survival outcomes.