Russell, N., Hills, R., Kjeldsen, L., Dennis, M. and Burnett, A. (2022) Treatment intensification with FLAG‐Ida may improve disease control in younger patients with secondary acute myeloid leukaemia: long‐term follow up of the MRC AML15 trial. British Journal of Haematology, 196(6), pp. 1344-1347. (doi: 10.1111/bjh.17974) (PMID:34904225)
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Abstract
Secondary acute myeloid leukaemia (AML) has a poor outcome following “3 + 7-like” chemotherapy. While CPX-351 has been approved for patients aged 60–75, the optimal treatment, or comparator, in younger patients is less clear. The MRC AML15 trial randomised younger patients between daunorubicin and ara-C (DA) and DA plus etoposide (ADE) and ADE and fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor (FLAG-Ida) induction. Overall results failed to show an overall survival benefit for FLAG-Ida despite a reduction in relapse, the outcome of patients <60 years with secondary AML compared to DA/ADE was not reported. In this group (n = 115) response to induction was not different [complete remission/complete remission with incomplete haematological response 81% vs. 79%), however, 5-year overall survival and relapse free survival was superior for FLAG-Ida [37% vs. 27%, stratified hazard ratio (HR) 0·45 (0·33–0·90) P = 0·02 and 41% vs. 22%; stratified HR 0·54 (0·31–0·96) P = 0·04] respectively, suggesting that younger patients with secondary AML may benefit from treatment intensification and that “3 + 7” may not be the optimal comparator in trials for this group of patients.
Item Type: | Articles |
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Additional Information: | This work was supported by a research grant from Cancer UK. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Burnett, Professor Alan |
Authors: | Russell, N., Hills, R., Kjeldsen, L., Dennis, M., and Burnett, A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Cancer Sciences |
Journal Name: | British Journal of Haematology |
Publisher: | Wiley |
ISSN: | 0007-1048 |
ISSN (Online): | 1365-2141 |
Published Online: | 13 December 2021 |
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