在NPM1-突变AML中,强化诱导化疗与与venetoclax结合的低甲基化剂对比
Jan Philipp Bewersdorf1, Shai Shimony2, Rory M Shallis3
1Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, NY.
Blood advances
|June 28, 2024
概括
对于具有NPM1突变的老年急性髓性白血病患者,密集化疗 (IC) 和低甲基化剂加上venetoclax (HMA/VEN) 显示出类似的缓解率. 在多变量分析中,总生存率在IC和HMA/VEN之间没有显著差异.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床试验 临床试验
背景情况:
- 强化诱导化疗 (IC) 是年轻急性髓性白血病 (AML) 患者的标准.
- 低甲基化剂加上venetoclax (HMA/VEN) 在具有NPM1突变的老年AML患者中显示持久缓解.
- 在较老的NPM1突变AML中,IC与HMA/VEN的比较疗效尚未得到充分证实.
研究的目的:
- 为了比较强化诱导化疗 (IC) 和低甲基化剂加上venetoclax (HMA/VEN) 在60岁或以上,先前未经治疗的NPM1-突变性急性髓性白血病 (AML) 患者的疗效.
主要方法:
- 国际,多中心回顾性队列研究.
- 221名患者先前未接受过治疗的NPM1-突变AML (147 IC,74 HMA/VEN).
- 复合完全缓解 (cCR) 和整体存活 (OS) 的分析.
主要成果:
- 对于IC和HMA/VEN (85%对74%,P=0.067) 的复合完全缓解 (cCR) 率相似.
- 在多变量分析中,整体存活率 (OS) 在IC和HMA/VEN之间没有统计差异 (HR 0.71,P=0.25).
- 亚组分析表明,在正常细胞遗传学或没有FLT3-ITD突变的患者中,IC的潜在益处.
结论:
- 在60岁以上的NPM1突变AML患者中,IC和HMA/VEN的缓解率相似.
- 在多变量分析时,IC和HMA/VEN之间的总生存结果在这个人群中没有显著差异.
- 治疗选择可能取决于患者特定的因素和子组特征.
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