Risk-adapted MRD-directed therapy for young adults with acute myeloid leukemia: 6-year update of the GIMEMA AML1310 trial
Adriano Venditti, Alfonso Piciocchi, Anna Candoni, Valentina Arena, Raffaele Palmieri, Carla Filì, Angelo Michele Carella, Valeria Calafiore, Roberto Cairoli, Paolo de Fabritiis, Gabriella Storti, Prassede Salutari, Francesco Lanza, Giovanni Martinelli, Antonio Curti, Mario Luppi, Claudia Ingrosso, Maria Paola Martelli, Antonio Cuneo, Francesco Albano, Antonino Mulè, Agostino Tafuri, Laura Cudillo, Alessia Tieghi, Nicola Fracchiolla, Debora Capelli, Silvia Maria Trisolini, Caterina Alati, Edoardo La Sala, Luca Maurillo, Maria Ilaria Del Principe, María Antonietta Irno Consalvo, Maria Domenica Divona, Tiziana Ottone, Raffaella Cerretti, Giuseppe Sconocchia, Maria Teresa Voso, Paola Fazi, Marco Vignetti, Francesco Buccisano
Abstract
Intensive chemotherapy followed by allogeneic stem cell transplantation (ASCT) remains the mainstay for the treatment of fit patients with de novo acute myeloid leukemia (AML) aged <60 years.1,2 For patients who achieve remission with induction, appropriate selection of postremission therapy (including ASCT) using tools such as the European LeukemiaNet (ELN) risk stratification is essential to determine the patients’ risk of relapse and ASCT candidacy,1 to balance treatment-related mortality (primarily associated with ASCT), and the risk of relapse itself. Patients with a favorable genetic/cytogenetic profile are generally offered postconsolidation chemotherapy, whereas patients with adverse characteristics are offered ASCT. For those in the intermediate category, no consensus exists about the optimal postremission therapy.