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. 2018 Aug;93(8):1074-1081.
doi: 10.1002/ajh.25162.

Very poor long-term survival in past and more recent studies for relapsed AML patients: The ECOG-ACRIN experience

Chezi Ganzel  1 , Zhuoxin Sun  2 , Larry D Cripe  3 , Hugo F Fernandez  4 , Dan Douer  5 , Jacob M Rowe  1   6 , Elisabeth M Paietta  7 , Rhett Ketterling  8 , Michael J O'Connell  8 , Peter H Wiernik  9 , John M Bennett  10 , Mark R Litzow  8 , Selina M Luger  11 , Hillard M Lazarus  12 , Martin S Tallman  5
Affiliations

Very poor long-term survival in past and more recent studies for relapsed AML patients: The ECOG-ACRIN experience

Chezi Ganzel et al. Am J Hematol. 2018 Aug.

Abstract

This study examines the long-term OS of relapsed AML patients who were enrolled to 9 successive ECOG-ACRIN trials for newly diagnosed AML, during 1984-2008. The objectives were to examine whether there is a trend of improvement in the survival of relapsed AML patients in the more recent studies and to search for prognostic factors that are associated with long-term OS after relapse. A total of 3012 patients were enrolled, 1779 (59.1%) achieved CR1 and of these, 58.9% relapsed. The median follow-up was 9.7 years. The median OS from relapse was 0.5 years and the 5-year OS was 10 (±1)%. These results were similar even for the most recent studies. A multivariate model showed that age, cytogenetics at diagnosis, duration of CR1 and undergoing allogeneic transplantation were significantly associated with OS from relapse. Even among patients who relapsed with better prognostic factors; age < 40 and CR1 > 12 months, there was no significant OS difference between the studies. In conclusion, this large cohort appears to confirm that the survival of AML patients postrelapse continues to be dismal and has not improved during the past quarter of a century.

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Conflict of interest statement

CONFLICT OF INTEREST

No conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) OS from relapse by age—the entire cohort. (B) OS from relapse by age—the most recent study (E1900)
FIGURE 2
FIGURE 2
(A). OS from relapse of studies enrolling patients with age ≤ 55 or 60 years (continues variables). (B). OS from relapse of studies enrolling patients with age > 55 or 60 years (categorial variables)
FIGURE 3
FIGURE 3
OS from relapse, by duration of CR1 ≤/>12 months
FIGURE 4
FIGURE 4
OS from relapse of patients with age < 40 and CR1 > 12 months, by study
See this image and copyright information in PMC

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