Key clinical point: Optimization of a traditional induction regimen with idarubicin and cytarabine (IA) with additional homoharringtonine according to day 5 peripheral blast clearance rate (D5-PBCR) ³99.55% (D5-PBCR −) is feasible in patients with newly diagnosed acute myeloid leukemia (AML) with reversal of unfavorable outcomes observed in patients with D5-PBCR <99.55% (D5-PBCR+).
Major finding: Rates of composite complete remission after 1 cycle of induction (CR1) were 87.5% and 80.0% in D5-PBCR − and D5-PBCR+ groups, respectively, with CR1 rate improving by almost 18% in the D5-PBCR+ group compared with the historical data ( P = .049). The median overall survival, event-free survival, and grade 3 or higher adverse events were similar between the 2 groups.
Study details: Findings are from a phase 2 RJ-AML 2014 trial including 151 adult patients with untreated newly diagnosed AML who received a dose-reduced IA induction regimen. Patients with D5-PBCR+ (n = 65) received IA+homoharringtonine.
Disclosures: This study was supported by the Shanghai Jiao Tong University School of Medicine Multi-Center Clinical Research Project Grant and the National Natural Science Foundation of China. The authors declared no conflict of interests.
Source: Zhang Y et al. Am J Hematol. 2021(Oct 23). Doi: 10.1002/ajh.26386.