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

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

doi:10.3389/fonc.2022.1070588

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

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

Authors

Xiaoyu Wang¹, Dan Liu², Erling Chen³, Li Wang³, Na Zhao³, Li Zhou³, Juan Tong³, Lei Xue³, Lei Zhang³, Liangquan Geng³, Baolin Tang³, Huilan Liu³, Xin Liu³, Changcheng Zheng^{1

3}

Affiliations

¹ Department of Hematology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
² Department of Hematology, The Affiliated Provincial Hospital, Wannan Medical College, Wuhu, China.
³ Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.

Abstract

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 (p=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%) (p=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%) (p=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.

Keywords: 2022 European Leukemia Net; acute myeloid leukemia; consolidation; high-dose cytarabine; multiagent sequential chemotherapy.

Grants and funding

This work was partly supported by Key research and development projects In Anhui Province (202004j07020025), the Fundamental Research Funds for the Central Universities of China (WK9110000003).