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Comparison of the impact of two post-remission therapy regimens on cardiac events in acute myeloid leukemia patients undergoing allogeneic hematopoietic stem cell transplantation

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Abstract

High-dose cytarabine (HD-AraC) or anthracycline-containing chemotherapies are used as post-remission therapy for acute myeloid leukemia (AML) patients. However, it remains unclear which regimen would be better as post-remission therapy before allogeneic hematopoietic stem cell transplantation (allo-HSCT). Thus, we compared the incidence of cardiac events and event-free survival (EFS) after allo-HSCT at two Japanese hospitals between HD-AraC and anthracycline-containing post-remission therapy to clarify the safety of post-remission therapy. Of a total of 132 patients, 68 received HD-AraC (HD-AraC group) and 64 received anthracycline-containing chemotherapy (ANT group). HD-AraC was preferentially selected for core-binding factor AML patients (p = 0.008). The median cumulative anthracycline dose was 115.2 mg/m2 in the HD-AraC group and 318.7 mg/m2 in the ANT group (p < 0.0001). Cardiac events were observed in 18 (13.6%) patients during the follow-up period. The 3-year cumulative incidence of cardiac events was 9.1% in the HD-AraC group and 11.0% in the ANT group (p = 0.70). EFS at 3 years after allo-HSCT was 40.9% in the HD-AraC group and 39.6% in the ANT group (p = 0.51). In conclusion, incidence of cardiac events did not differ significantly between post-remission therapy regimens in AML patients who underwent allo-HSCT.

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Acknowledgements

We thank all hospital staff who were involved in patient care.

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Authors and Affiliations

  1. Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma Town, Omiya Ward, Saitama City, Saitama, 330-8503, Japan

    Jin Hayakawa, Hideki Nakasone, Ayumi Gomyo, Yu Akahoshi, Yusuke Komiya, Naonori Harada, Tomotaka Ugai, Kazuaki Kameda, Hidenori Wada, Yuko Ishihara, Koji Kawamura, Kana Sakamoto, Miki Sato, Kiriko Terasako-Saito, Misato Kikuchi, Shun-ichi Kimura, Junya Kanda, Shinichi Kako & Yoshinobu Kanda

  2. Division of Hematology, Department of Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0431, Japan

    Daisuke Minakata, Shin-ichiro Fujiwara & Yoshinobu Kanda

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Hayakawa, J., Nakasone, H., Minakata, D. et al. Comparison of the impact of two post-remission therapy regimens on cardiac events in acute myeloid leukemia patients undergoing allogeneic hematopoietic stem cell transplantation. Int J Hematol 116, 239–247 (2022). https://doi.org/10.1007/s12185-022-03343-7

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