Multicenter comparison of high-dose cytarabine-based regimens versus liposomal daunorubicin and cytarabine (CPX-351) in patients with secondary acute myeloid leukemia.

Autor: Benitez LL; Michigan Medicine, Ann Arbor, MI, USA.; College of Pharmacy, University of Michigan, Ann Arbor, MI, USA., Perissinotti AJ; Michigan Medicine, Ann Arbor, MI, USA., Rausch CR; The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Klaus J; Barnes Jewish Hospital, St. Louis, MO, USA., Clark SM; University of North Carolina Medical Center, Chapel Hill, NC, USA., Filtz M; Huntsman Cancer Institute, Salt Lake City, UT, USA., Ratermann K; Huntsman Cancer Institute, Salt Lake City, UT, USA., Treptow C; Department of Pharmacy, University of Rochester, Rochester, NY, USA., Griffin S; Indiana University Health, Indianapolis, IN, USA., Olson M; Barnes Jewish Hospital, St. Louis, MO, USA., Crain M; Barnes Jewish Hospital, St. Louis, MO, USA., Kadia T; The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Pettit K; Michigan Medicine, Ann Arbor, MI, USA., Burke PW; Michigan Medicine, Ann Arbor, MI, USA., Bixby DL; Michigan Medicine, Ann Arbor, MI, USA., Marini BL; Michigan Medicine, Ann Arbor, MI, USA.; College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: Leukemia & lymphoma [Leuk Lymphoma] 2021 Sep; Vol. 62 (9), pp. 2184-2192. Date of Electronic Publication: 2021 Apr 08.
DOI: 10.1080/10428194.2021.1907378
Abstrakt: Liposomal daunorubicin/cytarabine (CPX-351) gained FDA approval for secondary AML after demonstrating improved outcomes over daunorubicin and cytarabine (7 + 3). A number of study limitations prompted a comparison of safety/efficacy of CPX-351 against regimens containing a purine analogue and high-dose cytarabine (HIDAC). This retrospective study compared complete response rates with/without count recovery (CR/CRi) between HIDAC-based regimens and CPX-351 in 169 patients with newly diagnosed sAML. The CR/CRi rate was 62.7% in the HIDAC-based therapy arm vs. 47.9% in the CPX-351 arm ( p  = 0.002 [one-sided for non-inferiority]). Median time to absolute neutrophil and platelet count recovery was shorter after HIDAC-based therapy (18 and 23 days, respectively) compared to CPX-351 (36 and 38 days; p  < 0.001). Median overall survival was 9.8 months in the HIDAC-based group and 9.14 months in the CPX-351 group. 30-day mortality was greater with CPX-351 (8.5%) compared to HIDAC-based (1.3%; p  = 0.039). These results reveal comparable efficacy and favorable safety with HIDAC-based regimens.
Databáze: MEDLINE
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