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Outcomes with intensive treatment for acute myeloid leukemia: an analysis of two decades of data from the HARMONY Alliance

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Item Type:Article
Title:Outcomes with intensive treatment for acute myeloid leukemia: an analysis of two decades of data from the HARMONY Alliance
Creators Name:Sobas, M.A., Turki, A.T., Ramiro, A.V., Sánchez, A.H., Elicegui, J.M., González, T., Melchor, R.A., Abáigar, M., Tur, L., Dall'Olio, D., Sträng, E., Tettero, J.M., Castellani, G., Benner, A., Döhner, K., Thiede, C., Metzeler, K.H., Haferlach, T., Damm, F., Ayala, R., Martínez-López, J., Mills, K.I., Sierra, J., Lehmann, S., Porta, M.G.D., Mayer, J., Reinhardt, D., Medina, R.V., Schulze-Rath, R., Barbus, M., Hernández-Rivas, J.M., Huntly, B.J.P., Ossenkoppele, G., Döhner, H. and Bullinger, L.
Abstract:Since 2017, targeted therapies combined with conventional intensive chemotherapy have started to improve outcomes of patients with acute myeloid leukemia (AML). However, even before these innovations, outcomes with intensive chemotherapy had improved, which has not yet been extensively studied. Thus, we used a large pan-European multicenter dataset of the HARMONY Alliance to evaluate treatment-time dependent outcomes over two decades. In 5,359 AML patients, we compared the impact of intensive induction therapy on outcome over four consecutive 5-year calendar periods from 1997 to 2016. During that time, the 5-year survival of AML patients improved significantly, also across different genetic risk groups. In particular, the 60-day mortality rate dropped from 13.0% to 4.7% over time. The independent effect of calendar periods on outcome was confirmed in multivariate models. Improvements were documented both for patients <60 and ≥60 years old, and in those treated with and without consolidating allogeneic hematopoietic stem cell transplantation (alloHCT). While survival of AML elderly patients remains poor, patients ≥60 years old overall have a 20% survival benefit at 5 years if they receive an alloHCT. While further outcome improvement in intensively treated AML patients will likely be driven by targeted treatment approaches, this pan-European HARMONY dataset can serve as a multicenter comparator for future studies.
Keywords:Antineoplastic Combined Chemotherapy Protocols, Europe, Hematopoietic Stem Cell Transplantation, Acute Myeloid Leukemia, Prognosis, Treatment Outcome, Young Adult
Source:Haematologica
ISSN:0390-6078
Publisher:Ferrata Storti Foundation
Volume:110
Number:5
Page Range:1126-1140
Date:May 2025
Official Publication:https://doi.org/10.3324/haematol.2024.285805
PubMed:View item in PubMed

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