Efficacy of non-intensive therapies approved for relapsed/refractory acute myeloid leukemia: a systematic literature review.
T Alexander Russell-SmithLaura GurskyteBogdan MuresanCarla M MamoloAna GezinJoseph C CappelleriBart HeegPublished in: Future oncology (London, England) (2022)
Aim: De novo relapsed and/or refractory acute myeloid leukemia (rrAML) has limited treatment options for patients not eligible ('unfit') to receive intensive chemotherapy-based interventions. The authors aimed to summarize outcomes for licensed therapies in this setting. Materials & methods: A systematic literature review identified licensed therapies in this setting. A feasibility assessment was made to conduct a network meta-analysis to evaluate comparative efficacy. Results: Seven unique trials were identified. Median survival months were 13.8 for gemtuzumab ozogamicin (GO), 9.3 for gilteritinib (FLT3 mutated rrAML), 5.6 for low-dose cytarabine and 3.2 for best supportive care; transplant rates with gilteritinib and GO were 25.5 and 19%, respectively. A network meta-analysis was not feasible. Conclusion: There remains a high unmet need in de novo rrAML patients not eligible for intensive therapy, with GO and gilteritinib (only FLT3-mutated AML) providing the best current options.
Keyphrases
- acute myeloid leukemia
- end stage renal disease
- allogeneic hematopoietic stem cell transplantation
- low dose
- newly diagnosed
- acute lymphoblastic leukemia
- ejection fraction
- chronic kidney disease
- healthcare
- peritoneal dialysis
- prognostic factors
- stem cells
- high dose
- physical activity
- radiation therapy
- mesenchymal stem cells
- adipose tissue
- bone marrow
- metabolic syndrome
- replacement therapy
- rectal cancer