ASH 2024 | Impact of intensive consolidation chemotherapy cycles on alloSCT outcomes in AML

This was a retrospective analysis that we did to try to see if there was an impact on the number of intensive chemotherapy plus venetoclax cycles on outcomes post stem cell transplant. Allogeneic stem cell transplant is typically the recommended kind of consolidative therapy for patients that have intermediate or high risk disease. We have a lot of these really excellent new intensive regimens that are currently under clinical trials such as Flag-Ida and venetoclax and CLIA and venetoclax and what we don’t know right now is how many intensive chemotherapy cycles are needed. As while these intensive chemotherapy cycles are able to show these really excellent outcomes for patients they also come with additional risks such as prolonged myelosuppression and neutropenic fever. And so what we did in this study is we looked at a total of 86 patients that had received either Flag-Ida-venetoclax or CLIA-venetoclax at our institution and then had gone on to proceed to transplants. And we looked at how many consolidative cycles that they had received prior to transplants and then looked at their outcomes post-transplant. And we separated patients based on those who had received either zero or one consolidated cycles and those who had received two or more. And we found that the overall survival and event-free survival after transplant did not differ whether or not they had received only zero or one or if they had received two or more. We also looked at a multivariable analysis to account for other factors as well, looking at things such as MRD negativity, the number of cycles, age, the risk of their disease overall. And in the multivariable analysis, there was no association between the number of consolidative intensive chemotherapy plus venetoclax cycles and either overall survival or relapse-free survival. There was a trend towards MRD positivity resulting in worse outcomes but still that also was not significant. And so I think this really highlights the importance of us trying to figure out how many cycles of these intensive chemotherapy plus venetoclax are really needed in patients’ planning to go for transplant.

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