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EHA 2021 | RIC transplant in CR1 for older AML patients

Nigel Russell, MD, University of Nottingham, Nottingham, UK, discusses the results of two sequential Phase III clinical trials investigating the possible benefits of reduced intensity conditioning (RIC) before allogenic hematopoietic stem cell transplant (allo-HSCT) for older patients with acute myeloid leukemia (AML). In the National Cancer Research Institute (NCRI) AML16 trial (CRUK/06/026), patients underwent double induction with daunorubicin and clofarabine or cytarabine (AraC) either with or without gemtuzumab. In the subsequent NCRI AML18 trial (CRUK/12/043), patients underwent double induction with daunorubicin and cytarabine (AraC) plus gemtuzumab. 15% of patients in complete remission 1 (CR1) in AML16 and 30% of patients in CR1 in AML18 underwent RIC transplant. There was no group among the AML16 patients who did not see a significant benefit, independent from response to the first course of treatment and measurable residual disease (MRD) status, after the RIC transplant. Therefore, the transplant decisions for patients in the AML18 trial were based on health status and donor availability. Interim results from AML18 show an overall three-year survival benefit of RIC transplant in comparison to chemotherapy. Prof. Russell gives an overview and compares findings from these trials, commenting on implications for clinical practice. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.

Disclosures

Nigel Russell, MD, has participated in a consultancy role for Abbvie, Astellas, Pfizer and Jazz Pharmaceuticals.