AML treatment efficacy varies by status, age, cytogenetic risk

Some of the important treatment options for patients with acute myeloid leukaemia (AML) include chemotherapy, targeted therapy, and immunotherapy, but the efficacy of these treatments may vary depending on AML status, age, and cytogenetic risk, according to a study.

In this study, the databases of PubMed, Embase, Web of Science, and Google Scholar were searched for relevant studies. The investigators assessed bias using Cochrane’s risk of bias tool and performed statistical analyses using Review Manager and Comprehensive Meta-Analysis software.

Forty-four studies met the eligibility criteria. Pooled results demonstrated the efficacy of high-dose (HDAC) vs standard dose (SDAC) cytarabine in induction therapy in improving the complete remission (CR) rate among younger adults but not older adults (odds ratio [OR], 1.29, 95 percent confidence interval [CI], 1.12–1.49; p=0.0004 and OR, 1.02, 95 percent CI, 0.80–1.29; p=0.87, respectively).

In consolidation therapy, HDAC provided a significant improvement in event-free survival (EFS) over SDAC (risk ratio [RR], 1.30, 95 percent CI, 1.04–1.62; p=0.02).

In pooled analysis, idarubicin (IDR) correlated with better CR rates than daunorubicin (DNR; OR, 1.34, 95 percent CI, 1.02–1.76; p=0.04). The results, however, do not support that IDR is more effective than mitoxantrone (MTZ) or that DNR is better than MTZ in inducing CR (OR, 0.88, 95 percent CI, 0.72–1.08; p=0.22 and OR, 0.85, 95 percent CI, 0.72–1.01; p=0.06, respectively).

In addition, the pooled composite complete response (CRc) rates for FLT3 inhibitors such as sorafenib, gilteritinib, and quizartinib were 56 percent, 31 percent, and 36 percent, respectively. Furthermore, the overall CRc rates were 49.6 percent (95 percent CI, 37–63) for patients treated with IDH inhibitors and 26 percent (95 percent CI, 18.7–35) for those who received immune checkpoint inhibitors.