根据欧洲白血病网2022年风险分层，对于成年（14至59岁）急性髓系白血病（AML）患者的巩固治疗，大剂量阿糖胞苷单药治疗优于基于标准剂量阿糖胞苷的多药序贯治疗周期。

High-dose cytarabine monotherapy is superior to standard-dose cytarabine- based multiagent sequential treatment cycle for consolidation treatment in adult (14-59 years) AML patients according to European Leukemia Net 2022 risk stratification.

作者信息

Wang Xiaoyu, Liu Dan, Chen Erling, Wang Li, Zhao Na, Zhou Li, Tong Juan, Xue Lei, Zhang Lei, Geng Liangquan, Tang Baolin, Liu Huilan, Liu Xin, Zheng Changcheng

机构信息

Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

Department of Hematology, The Affiliated Provincial Hospital, Wannan Medical College, Wuhu, China.

出版信息

Front Oncol. 2023 Jan 16;12:1070588. doi: 10.3389/fonc.2022.1070588. eCollection 2022.

INTRODUCTION

We firstly investigate based on 2022 European Leukemia Net (ELN) risk stratification, whether standard-dose cytarabine based multiagent sequential chemotherapy (SDMSC) is more beneficial than high-dose cytarabine (HDAC) monotherapy in consolidation for the survival of adult acute myeloid leukemia (AML) patients.

METHODS

One hundred and eighty-three AML patients with complete remission (CR) were evaluated.

RESULTS AND DISCUSSION

The 3-year relapse rate was 33.4% in the HDAC group and 50.5% in the SDMSC group (=0.066). The 3-year overall survival (OS) and event-free survival (EFS) rates in the HDAC group (69.2%, 60.7%) were significantly higher than that in the SDMSC group (50.8%, 42.1%) (=0.025, 0.019). For patients in the intermediate risk group, the 3-year OS and EFS rates in the HDAC group (72.5%, 56.7%) were higher than that in the SDMSC group (49.1%, 38.0%) (=0.028, 0.093). This study indicates that for young adult AML patients, HDAC consolidation achieves a higher long-term survival than SDMSC, especially for patients in the intermediate-risk group according to the 2022 ELN risk stratification.

引言

我们首先基于2022年欧洲白血病网络（ELN）风险分层，研究在巩固治疗中，基于标准剂量阿糖胞苷的多药序贯化疗（SDMSC）是否比大剂量阿糖胞苷（HDAC）单药治疗对成人急性髓系白血病（AML）患者的生存更有益。

方法

对183例完全缓解（CR）的AML患者进行评估。

结果与讨论

HDAC组的3年复发率为33.4%，SDMSC组为50.5%（=0.066）。HDAC组的3年总生存（OS）率和无事件生存（EFS）率（69.2%，60.7%）显著高于SDMSC组（50.8%，42.1%）（=0.025，0.019）。对于中危组患者，HDAC组的3年OS率和EFS率（72.5%，56.7%）高于SDMSC组（49.1%，38.0%）（=0.028，0.093）。本研究表明，对于年轻成人AML患者，HDAC巩固治疗比SDMSC能获得更高的长期生存率，尤其是根据2022年ELN风险分层的中危组患者。