Haematologica (Oct 2024)
Long-term survival can be achieved in a significant fraction of older patients with core binding factor acute myeloid leukemia treated with intensive chemotherapy
- Federico Mosna,
- Erika Borlenghi,
- Mark Litzow,
- John C. Byrd,
- Cristina Papayannidis,
- Cristina Tecchio,
- Felicetto Ferrara,
- Guido Marcucci,
- Roberto Cairoli,
- Elizabeth A. Morgan,
- Carmela Gurrieri,
- Cecilia C.S. Yeung,
- H. Joachim Deeg,
- Debora Capelli,
- Anna Candoni,
- Jason R. Gotlib,
- Monia Lunghi,
- Sheeja Pullarkat,
- Francesco Lanza,
- Sara Galimberti,
- Fabio Forghieri,
- Adriano Venditti,
- Moreno Festuccia,
- Ernesta Audisio,
- Denise Marvalle,
- Gian Matteo Rigolin,
- Giovanni Roti,
- Eros DiBona,
- Giuseppe Visani,
- Francesco Albano,
- Ann-Kathrin Eisfeld,
- Peter Valent,
- Gerwin Huls,
- Gautam Borthakur,
- Mauro Krampera,
- Giovanni Martinelli,
- Nicolaus Kröger,
- Alessandra Sperotto,
- Michele Gottardi
Affiliations
- Federico Mosna
- Hematology and BMTU, Hospital Hospital of Bolzano (SABES – ASDAA), Teaching Hospital of Paracelsus Medical University (PUM), Bolzano (BZ)
- Erika Borlenghi
- UOC Ematologia, ASST Spedali Civili, Brescia
- Mark Litzow
- Division of Hematology, Mayo Clinic, Rochester Minnesota
- John C. Byrd
- Department of Internal Medicine, University of Cincinnati, Cincinnati Ohio
- Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seragnoli”, Bologna
- Cristina Tecchio
- Hematology and Bone Marrow Transplantation Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona
- Felicetto Ferrara
- Hematology, Ospedale “Antonio Cardarelli”, Napoli
- Guido Marcucci
- Dept. of Hematological Malignancies Translational Science, City of Hope, Duarte California
- Roberto Cairoli
- Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano
- Elizabeth A. Morgan
- Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston Massachusetts
- Carmela Gurrieri
- Hematology, Azienda Ospedaliera di Padova, Padua
- Cecilia C.S. Yeung
- Translational Science and Therapeutics Division, Fred Hutchinson Cencer Center, Seattle, WA
- H. Joachim Deeg
- Translational Science and Therapeutics Division, Fred Hutchinson Cencer Center, Seattle, WA
- Debora Capelli
- Ospedali Riuniti di Ancona – Azienda Ospedaliero Universitaria delle Marche, Ancona
- Anna Candoni
- Hematology, Azienda Ospedaliero-Universitaria di Udine, Udine
- Jason R. Gotlib
- Hematology, Stanford Cancer Center Palo Alto, Palo Alto California
- Monia Lunghi
- Hematology, AOU Maggiore della Carità, Novara
- Sheeja Pullarkat
- Department of Pathology, David Geffen School of Medicine at UCLA, Los Angeles CA
- Francesco Lanza
- Dip DIMEC-Universita’ degli Studi di Bologna, UO Ematologia – Rete Trapianti CSE Romagna and Centro Studi Clinici Fase 1, Ospedale di Ravenna
- Sara Galimberti
- Hematology, Department of Clinical and Experimental Medicine, University of Pisa
- Fabio Forghieri
- Hematology, Azienda Ospedaliero-Universitaria di Modena, Modena
- Adriano Venditti
- Hematology, Dept. of Biomedicine and Prevention, University “Tor Vergata”, Rome
- Moreno Festuccia
- Hematology, Azienda USL della Valle d’Aosta, Aosta
- Ernesta Audisio
- Hematology, Città della Salute e della Scienza di Torino, University of Turin, Torino
- Denise Marvalle
- Hematology and Cellular Therapy, Ospedale Mazzoni, Ascoli Piceno
- Gian Matteo Rigolin
- Hematology, Azienda Ospedaliero Universitaria “S. Anna”, Ferrara
- Giovanni Roti
- Hematology, Azienda Ospedaliero-Universitaria di Parma, Parma
- Eros DiBona
- Hematology, Ospedale “San Bortolo”, Azienda ULSS8 Berica, Vicenza
- Giuseppe Visani
- Hematology, Hematology, AST1, Pesaro
- Francesco Albano
- Hematology and Stem Cell Transplant Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, Bari
- Ann-Kathrin Eisfeld
- Clara D. Bloomfield Center for Leukemia Outcomes Research, 31Division of Hematology, Department of Internal Medicine, The Ohio State Universisty, Columbus, Ohio
- Peter Valent
- Department of Internal Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncoloy, Medical University of Vienna, Vienna
- Gerwin Huls
- Hematology, University of Groningen, Groningen
- Gautam Borthakur
- Dept. Of Leukemia, MD Anderson Cancer Center, Houston Texas
- Mauro Krampera
- Hematology and Bone Marrow Transplantation Unit, Section of Biomedicine of Innovation, Department of Engineering for Innovative Medicine, University of Verona
- Giovanni Martinelli
- Istituto Romagnolo per lo Studio dei Tumori “Dino Amadori”, IRST-IRCCS Meldola
- Nicolaus Kröger
- Dept. of Stem Cell Transplantation with Research Dept. Cell and Gene Therapy, University Medical Center Hamburg-Eppendorf, Hamburg
- Alessandra Sperotto
- Oncohematology, Dept. Of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua
- Michele Gottardi
- Oncohematology, Dept. Of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua
- DOI
- https://doi.org/10.3324/haematol.2024.285448
- Journal volume & issue
-
Vol. 999,
no. 1
Abstract
Acute Myeloid Leukemia is mainly a disease of the elderly: however, the knowledge on the outcomes of treatment in core binding factor AML (CBFAML) in older population, is limited. We retrospectively collected data on 229 patients with CBF- AML followed long-term in the last two decades. A 5-year overall survival (OS) of 44.2% (95%CI, 39.9-47.5) and a 5-year event – free survival (EFS) of 32.9% (95%CI, 25.5-40.1) was observed. In a subgroup of >70-year patients who completed intensive therapy (induction + >3 courses of consolidation including autologous stem cell transplant: 10 patients) the median EFS was 11.8 months (95%CI, 9.4 – 15.2) and OS was 40.0% (95%CI, 36.4 – 44.1) at 5yr. In univariate analysis, age >70 (hazard ratio (HR) 1.78, [95%CI, 1.15 – 2.54], p=.008), failure to achieve remission following induction (HR, 8.96 [95%CI, 5.5 – 13.8], p=<.0001), no consolidation therapy (HR, 0.75 [95%CI, 0.47 – 1.84], p=.04) and less than 3 cycles of consolidation (HR, 1.48 [95%CI, 0.75 – 3.2], p=.0004), predicted poorer EFS. Our study shows that intensive therapy, in selected older CBF-AML patients, leads to longer survival. Achieving a CR seems to be the most important first step and at least 3 cycles of consolidation, an important second one. The analysis suggests that these patients should not be excluded from studies with intensive therapies.
