KEY TAKEAWAYS
- The study aimed to investigate the ORR of R/R AML patients treated with an MEC salvage regimen.
- The primary objective was to determine ORR.
- Researchers noticed that MEC is effective for R/R AML, especially in low disease burden patients, despite common adverse events.
Most patients with acute myeloid leukemia (AML) face relapsed or refractory (R/R) disease post-initial induction chemotherapy, necessitating salvage therapy followed by allogeneic hematopoietic stem cell transplantation (alloHSCT) for potential cure. At Cleveland Clinic, Mitoxantrone, etoposide, and cytarabine (MEC) are the established standard of care for R/R AML. The study’s primary objective was to ascertain the overall remission rate (ORR).
Sharon Zhong and the team aimed to assess the efficacy of MEC as a salvage regimen in R/R AML patients, particularly focusing on the ORR, defined as achieving complete remission (CR) or complete remission with incomplete hematologic recovery (CRi), and evaluating the impact of disease burden on treatment outcomes.
Researchers performed an inclusive analysis encompassing adult patients with R/R AML treated with MEC between July 1, 2014, and September 30, 2022. They determined the ORR and its association with baseline characteristics. Secondary outcomes examined included overall survival (OS), event-free survival (EFS), relapse-free survival (RFS), and safety.
About 60 patients were evaluated in the study. The ORR was 51.7% (33.3% CR and 18.3% CRi). The median time from receipt of MEC to CR/CRi was 7.7 weeks. Patients with bone marrow blasts ≤20% and peripheral blood blasts ≤30% at MEC initiation were more than twice as likely to achieve CR/CRi compared to those with a higher blast burden. The median OS was 6.3 months. Twenty-four (40.0%) patients proceeded to alloHSCT, while 21 (35.0%) patients were transferred to the intensive care unit (ICU) during their admission.
The study concluded that MEC serves as an effective salvage regimen for patients with R/R AML, particularly in those with low disease burden at initiation. However, it was noted that febrile neutropenia, infections, and severe oral mucositis were common adverse events associated with MEC administration.
The study received no funds.
Source: https://pubmed.ncbi.nlm.nih.gov/38460433/
Zhong S, Kurish H, Walchack R, et al. (2024). “Efficacy and safety of mitoxantrone, etoposide, and cytarabine for treatment of relapsed or refractory acute myeloid leukemia.” Leuk Res. 2024 Apr;139:107468. doi: 10.1016/j.leukres.2024.107468. Epub 2024 Feb 27. PMID: 38460433.
