Measurable residual disease in elderly acute myeloid leukemia: results from the PETHEMA-FLUGAZA phase 3 clinical trial

• Published in: Blood advances 2021-02, Vol.5 (3), p.760-770
• Main Authors: Simoes, Catia, Paiva, Bruno, Martínez-Cuadrón, David, Bergua, Juan-Miguel, Vives, Susana, Algarra, Lorenzo, Tormo, Mar, Martinez, Pilar, Serrano, Josefina, Herrera, Pilar, Ramos, Fernando, Salamero, Olga, Lavilla, Esperanza, Gil, Cristina, Lopez, Jose-Luis, Vidriales, Maria-Belen, Labrador, Jorge, Falantes, Jose-Francisco, Sayas, María-José, Ayala, Rosa, Martinez-Lopez, Joaquin, Villar, Sara, Calasanz, Maria-Jose, Prosper, Felipe, San-Miguel, Jesús F., Sanz, Miguel Ángel, Montesinos, Pau
• Format: Article
• Language: English
• Subjects: Aged; Cytarabine; Humans; Leukemia, Myeloid, Acute - diagnosis; Leukemia, Myeloid, Acute - drug therapy; Leukemia, Myeloid, Acute - genetics; Myeloid Neoplasia; Neoplasm, Residual; Prognosis; Remission Induction
• ISSN: 2473-9529; 2473-9537
• DOI: 10.1182/bloodadvances.2020003195

The value of measurable residual disease (MRD) in elderly patients with acute myeloid leukemia (AML) is inconsistent between those treated with intensive vs hypomethylating drugs, and unknown after semi-intensive therapy. We investigated the role of MRD in refining complete remission (CR) and treatment duration in the phase 3 FLUGAZA clinical trial, which randomized 283 elderly AML patients to induction and consolidation with fludarabine plus cytarabine (FLUGA) vs 5-azacitidine. After consolidation, patients continued treatment if MRD was ≥0.01% or stopped if MRD was