Klingler Felix, Alsdorf Winfried H, Ghandili Susanne, Wolschke Christine, Brauneck Franziska, Bokemeyer Carsten, Fiedler Walter, Modemann Franziska, Karagiannis Panagiotis
Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Stem cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Leuk Lymphoma. 2022 Nov;63(11):2645-2651. doi: 10.1080/10428194.2022.2092855. Epub 2022 Jul 5.
Recently new treatments for acute myeloid leukemia (AML) emerged, including regimens like CPX-351 and cladribine with cytarabine and daunorubicin (DA + C), demonstrating improved survival in patient subsets. This retrospective analysis is comparing the outcome of 124 patients treated with cytarabine and daunorubicin (DA; = 54), CPX-351 ( = 26) and DA + C ( = 44). Complete response rate following one cycle of therapy was increased in DA + C (62%) compared to CPX-351 (42%) and DA (50%). CPX-351 demonstrated a significant increased survival post allogenic stem cell transplantation against DA (hazard ratio (HR): 4.9; 95% confidence interval (95%CI): 1.1-21, = 0.03). Median survival was reached for DA (5.6 years) but not for DA + C or CPX-351. Subgroup analysis showed that AML with myelodysplasia-related changes and therapy-related AML treated with CPX-351 had increased survival compared to DA (HR: 5.2; 95%CI: 1.2-22; = 0.03). Our findings point twoards a CPX-351 superiority. However, the use of DA + C should be further evaluated in comparative studies.
最近出现了针对急性髓系白血病（AML）的新疗法，包括CPX - 351以及克拉屈滨联合阿糖胞苷和柔红霉素（DA + C）等方案，在部分患者亚组中显示出生存期改善。这项回顾性分析比较了124例接受阿糖胞苷和柔红霉素（DA；n = 54）、CPX - 351（n = 26）和DA + C（n = 44）治疗的患者的结局。与CPX - 351（42%）和DA（50%）相比，DA + C治疗一个周期后的完全缓解率有所提高（62%）。与DA相比，CPX - 351在异基因干细胞移植后显示出生存期显著延长（风险比（HR）：4.9；95%置信区间（95%CI）：1.1 - 21，P = 0.03）。DA达到了中位生存期（5.6年），但DA + C和CPX - 351未达到。亚组分析显示，与DA相比，CPX - 351治疗的伴有骨髓增生异常相关改变的AML和治疗相关AML患者生存期延长（HR：5.2；95%CI：1.2 - 22；P = 0.03）。我们的研究结果表明CPX - 351具有优势。然而，DA + C的应用应在比较研究中进一步评估。
