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

Chezi Ganzel, Zhuoxin Sun, Larry D. Cripe, Hugo F. Fernandez, Dan Douer, Jacob M. Rowe, Elisabeth M. Paietta, Rhett Ketterling, Michael J. O'Connell, Peter H. Wiernik, John M. Bennett, Mark R. Litzow, Selina M. Luger, Hillard M. Lazarus, Martin S. Tallman

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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.

Original languageEnglish (US)
Pages (from-to)1074-1081
Number of pages8
JournalAmerican Journal of Hematology
Volume93
Issue number8
DOIs
StatePublished - Aug 2018

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ASJC Scopus subject areas

  • Hematology

Cite this

Ganzel, C., Sun, Z., Cripe, L. D., Fernandez, H. F., Douer, D., Rowe, J. M., Paietta, E. M., Ketterling, R., O'Connell, M. J., Wiernik, P. H., Bennett, J. M., Litzow, M. R., Luger, S. M., Lazarus, H. M., & Tallman, M. S. (2018). Very poor long-term survival in past and more recent studies for relapsed AML patients: The ECOG-ACRIN experience. American Journal of Hematology, 93(8), 1074-1081. https://doi.org/10.1002/ajh.25162