Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: A report from SWOG and MD Anderson

M. Othus, H. Kantarjian, S. Petersdorf, F. Ravandi, J. Godwin, J. Cortes, S. Pierce, H. Erba, S. Faderl, F. R. Appelbaum, E. Estey

Research output: Contribution to journalArticle

80 Scopus citations

Abstract

Less-intense remission induction regimens for adults with newly diagnosed acute myeloid leukemia (AML) aim to reduce treatment-related mortality (TRM), here defined as death within 4 weeks after starting induction therapy. This assumes that TRM rates are similar to the 15-20% observed 20 years ago. Herein we test this assumption. We examined TRM rates in 1409 patients treated on SWOG (Southwest Oncology Group) trials and 1942 patients treated at MD Anderson (MDA) from 1991 to 2009. Eighty-eight percent of SWOG patients received '3+7' or regimens of similar intensity while 92% of the MDA patients received ara-C at 1.5-2.0 g/m 2 daily × 3-5 days+other cytotoxic agents. We examined the relationship between time and TRM rates after accounting for other covariates. TRM rates between 1991 and 2009 decreased from 18-3% in SWOG and 16-4% at MDA. Multivariate analyses showed a significant decrease in TRM over time (P=0.001). The decrease in TRM was not limited to younger patients, those with a better performance status or a lower white blood cell count. Though our observations are limited to patients treated with intensive therapy at SWOG institutions and MDA, the decrease in TRM with time emphasizes the problem with historical controls and could be considered when selecting AML induction therapy.

Original languageEnglish (US)
Pages (from-to)289-292
Number of pages4
JournalLeukemia
Volume28
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

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Keywords

  • 3+7
  • AML
  • high dose cytarabine
  • induction therapy
  • supportive care
  • treatment-related mortality

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Othus, M., Kantarjian, H., Petersdorf, S., Ravandi, F., Godwin, J., Cortes, J., Pierce, S., Erba, H., Faderl, S., Appelbaum, F. R., & Estey, E. (2014). Declining rates of treatment-related mortality in patients with newly diagnosed AML given 'intense' induction regimens: A report from SWOG and MD Anderson. Leukemia, 28(2), 289-292. https://doi.org/10.1038/leu.2013.176