Meta-Analysis Compares Efficacy of Therapeutic Interventions for AML

A study presented at the Society of Hematologic Oncology 2024 Annual Meeting offered a meta-analysis of a range of therapeutic approaches for the treatment of acute myeloid leukemia (AML). The study included efficacy data on interventions such as chemotherapy, targeted therapies (eg, FMS-like tyrosine kinase 3 and isocitrate dehydrogenase inhibitors), immunotherapy, hematopoietic stem cell transplantation (HSCT), and supportive care.

The researchers conducted a comprehensive literature review of PubMed, Embase, Web of Science, and Google Scholar databases, and 11 studies were included. The endpoints evaluated were complete response, objective response rate, event-free survival, relapse-free survival, and overall survival (OS).

The use of poly(ADP-ribose) polymerase (PARP) inhibitors was associated with an increased risk of myelodysplastic syndromes. Lactate dehydrogenase <400 U/L and induction treatment were associated with longer OS. Patients receiving induction therapy were more likely to have an extended hospitalization compared with patients receiving cytoreductive chemotherapy (55% vs 50%). The median survival associated with chemotherapy was 15.7 months, compared with 2.9 months for allogeneic HSCT.

Intravenous busulfan-based conditioning with cyclophosphamide (Bu/Cy) plus total body irradiation (TBI) was not associated with a significant OS benefit. In a comparison of intravenous (IV) Bu/Cy and Cy/TBI, leukemia-free survival was 61% with IV Bu/Cy and 64% with Cy/TBI. There were no significant differences in survival rates between conditioning with Bu/Cy and Cy/TBI in patients undergoing allogeneic HSCT.

“This meta-analysis offers valuable insights into AML treatment, emphasizing the importance of personalized therapeutic strategies and ongoing research,” the authors concluded. “Even though some interventions, such as PARP inhibitors, can cause adverse events, others, such as IV busulfan-based conditioning and allogeneic HSCT, offer hope for refractory leukemia patients.”

Reference

Altaf F, Qureshi Z, Jamil A, et al. Meta-analysis of therapeutic approaches in acute myeloid leukemia: unveiling trends and predictors of treatment response. Abstract #AML-356. Society of Hematologic Oncology 2024 Annual Meeting; Sept. 4-7, 2024; Houston, Texas.