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Survival outcomes in older patients with acute myeloid leukemia (AML) have significantly improved with reduced-intensity conditioning followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, it is uncertain whether cytarabine-based standard remission induction chemotherapy (3 + 7) is optimal before allo-HSCT. Lübbert et al.1 recently published the results of a phase III trial of decitabine vs intensive chemotherapy followed by allo-HSCT in older patients with AML (NCT02172872) in Lancet Hematology. Here, we are pleased to summarize the key findings.
This open-label randomized controlled trial included 606 patients aged ≥60 years with newly diagnosed AML who were eligible for intensive chemotherapy. The study design and patient characteristics have been previously reported by the AML Hub. The median age was 68 years (range, 60–81 years), and 92% of patients had an Eastern Cooperative Oncology Group performance status of 0 to 1.
Figure 1. 4-year survival outcomes*
DFS, disease-free survival; OS, overall survival; PFS, progression-free survival.
*Adapted from Lübbert, et al.1
Figure 2. Subgroup analysis: response rates by age and ELN risk group*
ELN, European LeukemiaNet.
*Adapted from Lübbert, et al.1
Figure 3. Adverse events*
AEs, adverse events.
*Adapted from Lübbert, et al.1
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