# Comparison of the efficacy of continuous VA chemotherapy and I/HDAC consolidation in postremission therapy for acute myeloid leukemia fit for standard chemotherapy

## TL;DR

This study compares two post-remission treatment approaches for acute myeloid leukemia and finds that one may offer better survival in specific patient subgroups.

## Contribution

The study provides a retrospective comparison of VA continuous chemotherapy versus I/HDAC consolidation in AML patients.

## Key findings

- I/HDAC consolidation showed longer overall survival in specific AML subgroups (ELN low-risk, MRD positive, FLT3 wild-type, IDH1/2 mutated).
- VA continuous chemotherapy had lower rates of severe side effects compared to I/HDAC consolidation.
- No statistically significant difference in overall survival was found between the two treatment groups overall.

## Abstract

比较维奈克拉联合阿扎胞苷（VA）持续化疗和中大剂量阿糖胞苷（I/HDAC）巩固强化治疗对缓解后转FIT（Fit for standard chemotherapy）状态急性髓系白血病（AML）的疗效及安全性。

收集2020年8月至2024年1月在河北医科大学第二医院血液科经VA方案诱导治疗后FIT状态患者的缓解后治疗临床资料，回顾性分析VA持续化疗和I/HDAC治疗方案疗效差异，观察指标包括总生存（OS）期、无复发生存（RFS）期、无事件生存（EFS）期，以及化疗相关不良反应发生率。

共收集69例患者资料，其中VA方案持续治疗组46例，I/HDAC巩固强化化疗组23例。VA组中位OS、RFS、EFS期分别为26.18、24.69、20.34个月，I/HDAC组分别为34.14、30.99、28.42个月，差异均无统计学意义（P值均>0.05）。I/HDAC组中欧洲白血病网（ELN）低危、微小残留病（MRD）阳性、FLT3野生型和IDH1/2突变亚组的中位OS期较VA组中相应亚组延长（P值均<0.05）。VA组3～4级粒细胞减少、3～4级血小板减少及血流感染发生率显著低于I/HDAC组（P值均<0.05）。

对于ELN低危、MRD阳性、FLT3野生型或IDH1/2突变的缓解后FIT状态AML患者，接受I/HDAC巩固强化化疗可能较持续VA化疗OS期延长。缓解后VA持续化疗安全性优于I/HDAC巩固强化化疗。