Dr. Erba on Treatment-Related Mortality Rates in AML

Harry Erba, MD, PhD, professor of medicine and director, University of Alabama at Birmingham Hematologic Malignancy Program, explains the declining treatment-related mortality (TRM) rates in AML patients.

In the last 20 years, Erba says, the outcomes of patients undergoing allogeneic hematopoietic stem cell transplant for AML has improved. There have been advances in the treatment such as better prophylaxis against fungal infections, better prophylaxis against cytomegalovirus reactivation, and human leukocyte antigen typing.

A report by the Southwest Oncology Group (SWOG) and MD Anderson (MDA) Cancer Center found that a community-wide interest in the use of less-intesive treatments than the standard 3+7 chemotherapy produced lower TRM rates from 1991-2009. In the SWOG group, TRM fell from 18% in the 1991-1995 period, to 13% in the 1996-2000 period, to 12% in the 2001-2005 period, and to 3% in the 2006-2009 period. The MDA group TRM declined in a similar fashion: from 16% in the 1991-1995 period, to 14% in the 1996-2000 period, to 9% in the 2001-2005 period, and to 4% in the 2006-2009 period.

The report concluded that there has been a reduction in TRM following “intensive” induction possibly due to better supportive care.

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