Key Presentations on Acute Myeloid Leukemia From ASH 2020

Eunice S. Wang, MD


December 29, 2020

Dr Eunice Wang reviews several key studies on acute myeloid leukemia (AML) presented at the 2020 American Society of Hematology Annual Meeting and Exposition.

Dr Wang highlights the results of a phase 3 multicenter, open-label study of gilteritinib plus azacytidine, or azacytidine alone, in newly diagnosed AML patients with FLT3-mutant disease who were considered ineligible for intensive chemotherapy. The study found the combination to be well tolerated, with encouraging signs of efficacy.

Dr Wang also reports on the 5-year final results of a phase 3 trial of CPX-351(liposomal cytarabine-daunorubicin) vs conventional 7 + 3 chemotherapy in older adults with secondary or high-risk AML who were considered eligible for intensive chemotherapy.

In this study, individuals receiving CPX induction consolidation followed by allogeneic transplantation had a 3-year survival rate of 56% compared with 23% in those in the control group.

Finally, Dr Wang discusses a study of CC-486, the first oral chemotherapy approved for maintenance therapy for AML patients. Out of the 103 patients who were randomly assigned to receive oral azacytidine or placebo and who were positive for minimal residual disease (MRD), 37% achieved an MRD-negative status after initiation of chemotherapy with oral azacytidine.

Hematopoietic cell transplantation (HCT) was received by 53 (35%) and 39 (25%) patients in the CPX-351 and 7 + 3 arms, respectively. Among patients who underwent HCT, the Kaplan-Meier–estimated survival rate landmarked from the date of HCT was higher for CPX-351 vs 7+3 at 3 years (56% vs 23%), and median OS landmarked from the date of HCT was not reached for CPX-351 vs 10.25 months for 7 + 3 (HR = 0.51 [95% CI, 0.28-0.90]).


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