Alice Mims, Zhuoer Xie, Ravi Potluri, David Rotter, Manoj Chevli, Thomas Prebet, Lona Gaugler, Maria Strocchia, Alberto Vasconcelos, Jan Sieluk
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引用次数: 0
摘要
新确诊的急性髓性白血病(ND AML)患者在接受强化化疗(IC)后病情得到缓解,但不适合接受移植治疗,建议将口服阿扎胞苷(Oral-AZA)作为维持治疗方案;不适合接受IC治疗的患者建议使用venetoclax加注射用阿扎胞苷(VEN-AZA)。有些患者可能被认为适合这两种方案。这项回顾性研究利用 Flatiron Health 的数据库,比较了 IC(ICᾆOral-AZA)后口服阿扎胞苷维持治疗与一线 VEN-AZA 的治疗模式和临床结果。在4个不同的时间点分析了无复发生存期(RFS)和总生存期(OS),包括核心分析中从口服AZA开始(ICᾆOral-AZA队列)或从缓解开始(VEN-AZA队列)。在核心分析中,ICᾆOral-AZA和VEN-AZA倾向评分匹配队列的中位RFS分别为14.9个月和8.1个月(各32人;p=0.027);中位OS分别为18.7个月和15.2个月(p=0.034)。与 VEN-AZA 相比,ICᾆOral-AZA 能显著改善 AML 患者的 RFS 和 OS。
Oral azacitidine maintenance after intensive chemotherapy versus venetoclax and azacitidine: real world outcomes in newly diagnosed acute myeloid leukemia.
Oral azacitidine (Oral-AZA) is recommended as maintenance therapy for patients with newly diagnosed acute myeloid leukemia (ND AML) achieving remission with intensive chemotherapy (IC) but not transplant candidates; venetoclax plus injectable azacitidine (VEN-AZA) is recommended for patients ineligible for IC. Some patients may be considered candidates for either regimen. This retrospective study used Flatiron Health's database to compare treatment patterns and clinical outcomes with Oral-AZA maintenance after IC (IC🡪Oral-AZA) versus frontline VEN-AZA. Relapse-free survival (RFS) and overall survival (OS) were analyzed at 4 different time points, including from Oral-AZA initiation (IC🡪Oral-AZA cohort) or from remission (VEN-AZA cohort) in the Core Analysis. Median RFS was 14.9 and 8.1 months for IC🡪Oral-AZA and VEN-AZA propensity score-matched cohorts, in the Core Analysis (n = 32 in each; p = 0.027); median OS was 18.7 and 15.2 months (p = 0.034). In patients with AML, IC🡪Oral-AZA significantly improved RFS and OS compared with VEN-AZA.
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor