Poor post-induction outcomes in patients with acute myeloid leukemia previously treated with hypomethylating agents

Abstract

Patients with acute myeloid leukemia (AML) who have failed hypomethylating agents (HMA) have a poor prognosis. We examined whether high intensity induction chemotherapy could abrogate negative outcomes in 270 patients with AML or other high-grade myeloid neoplasms. Prior HMA therapy was significantly associated with a lower overall survival (OS) as compared to a reference group of patients with secondary disease without prior HMA therapy (median 7.2 vs 13.1 months). In patients with prior HMA therapy, high intensity induction was associated with a non-significant trend toward longer OS (median 8.2 vs 4.8 months) and decreased rates of treatment failure (39% vs 64%). These results redemonstrate poor outcomes in patients with prior HMA and suggest possible benefit of high intensity induction that should be evaluated in future studies.

Keywords:

• Hypomethylating agent
• acute myeloid leukemia
• outcomes
• high intensity induction

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded in part by the Cancer Center Support Grant (NCI 5 P30 CA015704-48).