TY - JOUR
T1 - Inotuzumab ozogamicin in combination with low-intensity chemotherapy (mini-HCVD) with or without blinatumomab versus standard intensive chemotherapy (HCVAD) as frontline therapy for older patients with Philadelphia chromosome-negative acute lymphoblastic leukemia
T2 - A propensity score analysis
AU - Jabbour, Elias J.
AU - Sasaki, Koji
AU - Ravandi, Farhad
AU - Short, Nicholas J.
AU - Garcia-Manero, Guillermo
AU - Daver, Naval
AU - Kadia, Tapan
AU - Konopleva, Marina
AU - Jain, Nitin
AU - Cortes, Jorge
AU - Issa, Ghayas C.
AU - Jacob, Jovitta
AU - Kwari, Monica
AU - Thompson, Philip
AU - Garris, Rebecca
AU - Pemmaraju, Naveen
AU - Yilmaz, Musa
AU - O’Brien, Susan M.
AU - Kantarjian, Hagop M.
N1 - Publisher Copyright:
© 2019 American Cancer Society
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background: The outcome of older patients with newly diagnosed, Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) is poor. The combination of targeted therapy with low-intensity chemotherapy is safe and effective. The objective of the current analysis was to compare the outcome of patients who received a combination of inotuzumab ozogamicin plus low-intensity chemotherapy (mini–hyperfractionated cyclophosphamide, vincristine, and dexamethasone [mini-HCVD]) with or without blinatumomab versus the outcome of those who received the standard, intensive, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD) regimen. Methods: The authors analyzed 135 older patients with newly diagnosed, Ph-negative ALL who were treated prospectively with standard HCVAD (n = 77) or with the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab (n = 58). A propensity score analysis was conducted using 1:1 matching using the nearest neighbor matching method. Results: Propensity score matching identified 38 patients in each cohort. The antibody plus low-intensity chemotherapy combination induced higher response rates (98% vs 88%), with lower rates of early death (0% vs 8%) and lower rates of death in complete remission (5% vs 17%). With propensity score matching, the 3-year event-free survival rates for patients who received HCVAD and those who received the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab were 34% and 64%, respectively (P =.003), and the 3-year overall survival rates were 34% and 63%, respectively (P =.004). By multivariate analysis, age (P =.019; hazard ratio, 1.045) and the combination of inotuzumab plus mini-HCVD with or without blinatumomab (P =.020; hazard ratio, 0.550) were identified as independent prognostic factors for survival. Conclusions: The combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab is safe and effective in older patients with newly diagnosed, Ph-negative ALL and confers a better outcome compared with standard HCVAD chemotherapy.
AB - Background: The outcome of older patients with newly diagnosed, Philadelphia chromosome (Ph)-negative acute lymphoblastic leukemia (ALL) is poor. The combination of targeted therapy with low-intensity chemotherapy is safe and effective. The objective of the current analysis was to compare the outcome of patients who received a combination of inotuzumab ozogamicin plus low-intensity chemotherapy (mini–hyperfractionated cyclophosphamide, vincristine, and dexamethasone [mini-HCVD]) with or without blinatumomab versus the outcome of those who received the standard, intensive, hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (HCVAD) regimen. Methods: The authors analyzed 135 older patients with newly diagnosed, Ph-negative ALL who were treated prospectively with standard HCVAD (n = 77) or with the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab (n = 58). A propensity score analysis was conducted using 1:1 matching using the nearest neighbor matching method. Results: Propensity score matching identified 38 patients in each cohort. The antibody plus low-intensity chemotherapy combination induced higher response rates (98% vs 88%), with lower rates of early death (0% vs 8%) and lower rates of death in complete remission (5% vs 17%). With propensity score matching, the 3-year event-free survival rates for patients who received HCVAD and those who received the combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab were 34% and 64%, respectively (P =.003), and the 3-year overall survival rates were 34% and 63%, respectively (P =.004). By multivariate analysis, age (P =.019; hazard ratio, 1.045) and the combination of inotuzumab plus mini-HCVD with or without blinatumomab (P =.020; hazard ratio, 0.550) were identified as independent prognostic factors for survival. Conclusions: The combination of inotuzumab ozogamicin plus mini-HCVD with or without blinatumomab is safe and effective in older patients with newly diagnosed, Ph-negative ALL and confers a better outcome compared with standard HCVAD chemotherapy.
KW - blinatumomab
KW - inotuzumab
KW - mini-hyperfractionated cyclophosphamide, vincristine, and dexamethasone (mini-HCVD)
KW - older acute lymphoblastic leukemia (ALL)
KW - outcome
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U2 - 10.1002/cncr.32139
DO - 10.1002/cncr.32139
M3 - Article
C2 - 30985931
AN - SCOPUS:85064517337
SN - 0008-543X
VL - 125
SP - 2579
EP - 2586
JO - Cancer
JF - Cancer
IS - 15
ER -