Relative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studies.
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Here we quantify and compare the absolute and relative overall survival (OS) benefits conveyed by complete remission (CR) in AML and high-risk MDS, and by CR with incomplete count recovery (CRi) in AML and by hematologic improvement (HI) in MDS, following treatment with 7 + 3 versus azacytidine. We compared patients receiving 7 + 3 in SWOG studies S0106 (n = 301) and S1203 (n = 261) enrolling adults ≤ 60 years, with patients receiving azacytidine therapies in S0703 (n = 133 AML patients ≥ 60) and S1117 (n = 277 MDS patients ≥ 18). Absolute survival benefit was evaluated with 1-year, 3-year, and median OS; relative benefit was evaluated with univariate and covariate-adjusted hazard ratios. CR conveyed a relative survival advantage in multivariable analysis, with a similar relative effect of CR across studies. CR also conferred an absolute survival benefit, but with a smaller magnitude of absolute benefit in the azacytidine trials. In AML, OS was similar for CRi and failure to achieve CR/CRi. In MDS, CR conferred a survival advantage versus HI and HI versus failure. The relative survival benefit of CR was similar regardless of initial therapy for AML or high-risk MDS. With both therapies, CR has a beneficial effect on survival compared with CRi or HI.
Antineoplastic Combined Chemotherapy Protocols
Aged, 80 and over
Clinical Trials as Topic
Leukemia, Myeloid, Acute
Antibodies, Monoclonal, Humanized
Published Version (Please cite this version)10.1038/s41375-018-0275-x
Publication InfoOthus, Megan; Sekeres, Mikkael A; Nand, Sucha; Garcia-Manero, Guillermo; Appelbaum, Frederick R; Erba, Harry P; & Estey, Eli (2019). Relative survival following response to 7 + 3 versus azacytidine is similar in acute myeloid leukemia and high-risk myelodysplastic syndromes: an analysis of four SWOG studies. Leukemia, 33(2). pp. 371-378. 10.1038/s41375-018-0275-x. Retrieved from https://hdl.handle.net/10161/19544.
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Instructor in the Department of Medicine
I am a clinical investigator in the Division of Hematologic Malignancies and Cellular Therapy in the Department of Medicine. I serve as Director of the Leukemia Program and Director of Phase I Development in Hematologic Malignancies. I am also the Chair of the SWOG Leukemia Committee. I am interested in the clinical development of novel therapies for acute myeloid leukemia, myelodysplastic syndromes, myeloproliferative neoplasms (such as chronic myeloid leukemia, polycythemia v