Faculty, Staff and Student Publications

Publication Date

4-1-2025

Journal

Leukemia

Abstract

Intensive chemotherapy remains the standard for newly diagnosed (ND) acute myeloid leukemia (AML); however, relapse risk remains high. Additionally, most patients with relapsed/refractory (RR) AML have poor outcomes. We report the long-term experience of 138 patients, 77 ND and 61 RR, treated with FLAG-IDA in combination with venetoclax. In the ND cohort, the overall response rate (ORR) was 97%, with a composite complete remission (CRc) rate of 95% and undetectable measurable residual disease (MRD) status by flow cytometry in 90%. The 3-year OS and EFS rates were 66 and 64%, respectively. Outcomes were similar across European LeukemiaNet (ELN) 2022 risk groups. Sixty-four percent transitioned to allogeneic hematopoietic stem cell transplantation (allo-SCT) in CR1. In the RR cohort, the ORR was 67%; CRc rate 41% and flow negative MRD rate 74%; 57% transitioned to allo-SCT. The patients with RR AML in first salvage with wild-type TP53 status had particularly favorable outcomes, with an ORR of 79%, CRc rate of 74% (76% MRD undetectable) and 3-year OS rate of 51%. Infectious and hematologic adverse events were common, with low 30- and 60-day mortality similar to other intensive chemotherapy regimens. FLAG-IDA + VEN is effective for remission induction in both ND and RR AML.ClinicalTrials.gov Identifier: NCT03214562.

Keywords

Humans, Leukemia, Myeloid, Acute, Female, Male, Bridged Bicyclo Compounds, Heterocyclic, Middle Aged, Antineoplastic Combined Chemotherapy Protocols, Sulfonamides, Aged, Adult, Young Adult, Neoplasm Recurrence, Local, Hematopoietic Stem Cell Transplantation, Neoplasm, Residual, Cytarabine, Idarubicin, Remission Induction, Survival Rate, Consolidation Chemotherapy, Drug Resistance, Neoplasm, Follow-Up Studies, Induction Chemotherapy, Prognosis, Adolescent

DOI

10.1038/s41375-025-02531-8

PMID

40000842

PMCID

PMC11978487

PubMedCentral® Posted Date

4-9-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

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