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Posted by on Jun 27, 2020 in Leukemia | 0 comments

In a nutshell

This study aimed to compare two salvage regimes for patients with relapsed/refractory acute myeloid leukemia.  This study concluded that both regimens have similar effectiveness in terms of overall response but one shows a significant reduction in side effects in these patients.  

Some background

Patients with relapsed/refractory acute myeloid leukemia (R/R AML) commonly have poorer outcomes. The best treatment for R/R AML is salvage chemotherapy followed by allogeneic stem cell transplants (allo-HSCT). Salvage therapy is used when the initial treatment fails. Allo-HSCT involves taking healthy cells from a donor and transplanting them to the patient. This helps to replace cells that have been killed by previous treatment (like chemotherapy).  

The optimal salvage treatment for patients with R/R AML is still unknown.

Methods & findings

This study involved 155 patients with R/R AML. The two salvage regimes compared were mitoxantroneetoposide, and cytarabine (MEC) and mitoxantrone and high dose AraC (Ara-C couplets). 87 patients received MEC and 68 received Ara-C couplets.  

Overall response (OR) was achieved in 43.7% of the MEC group compared to 54.4% of the Ara-C group. Patients in the Ara-C group had slightly longer overall survival (OS) and progression-free survival (PFS) when compared to the MEC group.  

54.4% of the Ara-C group proceeded to alloHSCT compared to 31% of the MEC group.  

72% of the Ara-C group experienced a low number of white blood cells with fever compared to 94% of the MEC group. 2.94% of the Ara-C group experienced severe gastrointestinal side effects compared to 17.2% of the MEC group. 

The bottom line

This study concluded that although both regimens have equivalent similar in terms of overall response, Ara-C couplets treatment shows a significant reduction in side effects. 

The fine print

This study was based on medical records. The treatment was not randomized. Further controlled studies are needed.

Published By :

American Journal of Hematology

Date :

Apr 20, 2020

Original Title :

A Multi-institutional Comparison of Mitoxantrone, Etoposide, and Cytarabine (MEC) versus High-Dose Cytarabine and Mitoxantrone (Ara-C Couplets) Therapy for Patients with Relapsed or Refractory Acute Myeloid Leukemia.

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