Core-binding factor acute myeloid leukemia in first relapse: a retrospective study from the French AML Intergroup
Menée sur 145 patients atteints d'une forme de leucémie myéloïde aiguë (CBF-AML), cette étude rétrospective française évalue l'efficacité du gemtuzumab ozogamicine en traitement de sauvetage
Although CBF-AML (t(8;21) or inv(16)/t(16;16)) represents a favorable cytogenetic AML subgroup, 30-40% of these patients relapse after standard intensive chemotherapy. The encouraging results of GO in newly diagnosed AML and particularly in CBF-AML incited us to retrospectively investigate the impact of GO-based salvage in these patients. We retrospectively analysed the outcome of 145 patients with CBF-AML (59 t(8;21), 86 inv(16)/t(16;16)) in first relapse. As salvage, 48 patients received GO-based chemotherapy and 97 patients received conventional chemotherapy. Median age was 43 years (range, 16-76). Median CR1 duration was 12.1 months (range, 2.1-93.6). Overall, second complete remission (CR2) rate was 88%. With a median follow-up from relapse of 3.5 years, the estimated 5-year disease free survival (DFS) was 50% and 5-year overall survival (OS) was 51%. Older age and shorter CR1 duration was associated with a shorter OS. Patients treated with GO had similar CR2 rate but significantly higher 5-year DFS (68% vs 42%; p=.05) and OS (65% vs 44%; p=.02). In multivariate analysis, GO salvage was still associated with a significant benefit in DFS and OS. In the 78 patients who received alloSCT in CR2, GO before transplant significantly improved post-transplant DFS and OS without excess of treatment-related mortality.
Blood 2014