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

Author:

Rojek Alexandra E.1ORCID,McCormick Benjamin J.2,Cwykiel Joanna3,Odetola Oluwatobi3,Abaza Yasmin3,Nai Nhi4,Foucar Charles E.5ORCID,Achar Rohan K.6,Shallis Rory M.6,Bradshaw Danielle7,Standridge Meaghan8,Kota Vamsi7,Murthy Guru Subramanian Guru9,Badar Talha2,Patel Anand A.1ORCID

Affiliation:

1. Department of Medicine Section of Hematology/Oncology University of Chicago Chicago Illinois USA

2. Division of Hematology‐Oncology Blood and Marrow Transplantation Program Mayo Clinic Jacksonville Florida USA

3. Department of Medicine Division of Hematology and Oncology Robert H. Lurie Comprehensive Cancer Center Northwestern University Feinberg School of Medicine Chicago Illinois USA

4. Department of Internal Medicine University of New Mexico School of Medicine Albuquerque New Mexico USA

5. Department of Internal Medicine Division of Hematology and Oncology University of New Mexico School of Medicine Albuquerque New Mexico USA

6. Department of Internal Medicine Section of Hematology Yale School of Medicine Yale University New Haven Connecticut USA

7. Georgia Cancer Center Augusta University Augusta Georgia USA

8. Department of Internal Medicine Augusta University Medical College of Georgia Augusta Georgia USA

9. Division of Hematology/Oncology Medical College of Wisconsin Milwaukee Wisconsin USA

Abstract

AbstractCore‐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.

Publisher

Wiley

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