期刊
EUROPEAN JOURNAL OF HAEMATOLOGY
卷 109, 期 3, 页码 257-270出版社
WILEY
DOI: 10.1111/ejh.13805
关键词
allogeneic stem cell transplant; AML; induction chemotherapy; long-term follow-up; measurable residual disease; nationwide; randomized; survival
类别
资金
- Finnish Association of Hematology
- Tampere University Hospital
The AML-2003 study compared the long-term efficacy and safety of IAT and IdAraC-Ida in induction chemotherapy for AML and emphasized the importance of a treatment strategy guided by integrated genetic and clinical risk classification.
Objectives AML-2003 study sought to compare the long-term efficacy and safety of IAT and IdAraC-Ida in induction chemotherapy of acute myeloid leukemia (AML) and introduce the results of an integrated genetic and clinical risk classification guided treatment strategy. Methods Patients were randomized to receive either IAT or IdAraC-Ida as the first induction treatment. Intensified postremission strategies were employed based on measurable residual disease (MRD) and risk classification. Structured questionnaire forms were used to gather data prospectively. Results A total of 356 AML patients with a median age of 53 years participated in the study. Long-term overall survival (OS) and relapse-free survival (RFS) were both 49% at 10 years. The median follow-up was 114 months. No significant difference in remission rate, OS or RFS was observed between the two induction treatments. Risk classification according to the protocol, MRD after the first and the last consolidation treatment affected the OS and RFS significantly (p < .001). Conclusions Intensified cytarabine dose in the first induction treatment was not better than IAT in patients with AML. Intensification of postremission treatment in patients with clinical risk factors or MRD seems reasonable, but randomized controlled studies are warranted in the future.
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