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Real-world outcomes of intensive induction approaches in core binding factor acute myeloid leukemia.

Alexandra E RojekBenjamin J McCormickJoanna CwykielOluwatobi OdetolaYasmin AbazaNhi NaiCharles E FoucarRohan K AcharRory M ShallisDanielle BradshawMeaghan StandridgeVamsi KotaGuru Subramanian Guru MurthyTalha BadarAnand Ashwin Patel
Published in: EJHaem (2024)
Core-binding factor acute myeloid leukemia (CBF-AML) is characterized by the presence of inv(16)/t(16;16) or t(8;21) and is classified as a favorable risk by the 2022 European LeukemiaNet (ELN) guidelines. The CD33-targeting antibody-drug conjugate, gemtuzumab ozogamicin (GO), is commonly added to intensive chemotherapy (IC) in CBF-AML. We sought to compare outcomes in patients treated with IC with or without GO in CBF-AML. We included 200 patients with CBF-AML treated with IC across seven academic centers. Induction treatment regimens were categorized as IC alone, IC with GO, or IC with KIT inhibitor (dasatinib or midostaurin). Median follow-up for the whole cohort was 2.5 years. Three-year overall survival (OS) was 70% and 3-year event-free survival (EFS) was 51%. Patients treated with IC with GO experienced a 3-year EFS of 50% compared to those treated with IC alone who experienced a 3-year EFS of 47%, with no statistically significant difference ( p  = 0.62). Similarly, those treated with IC with GO did not experience an improved OS compared to those treated with IC alone ( p  = 0.67). Patients treated with IC with KIT inhibitor experienced a significantly improved 3-year EFS of 85% compared to those with IC with or without GO ( p  = 0.04). We find in our study that there is no survival benefit in patients treated with IC with the addition of GO; improved EFS was seen in patients with CBF-AML treated with IC plus KIT inhibitors, consistent with outcomes noted in prospective studies utilizing this approach.
Keyphrases
  • acute myeloid leukemia
  • free survival
  • squamous cell carcinoma
  • acute lymphoblastic leukemia
  • skeletal muscle
  • newly diagnosed
  • insulin resistance
  • clinical practice
  • binding protein