Key clinical point: Among patients with myeloid blast phase chronic myeloid leukemia (CML-MBP), combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) resulted in better clinical outcomes vs TKI alone.
Major finding: IC/HMA+TKI vs TKI alone resulted in higher rates of complete remission (CR) or CR with incomplete count recovery (57.5% vs 33.9%), complete cytogenic response (45.0% vs 10.7%), major/deep molecular response (24.2% vs 4.3%;), and more patients proceeding to allogeneic stem cell transplant (32.5% vs 10.7%). In patients receiving the second/third generation TKIs, IC/HMA+TKI led to superior 5-year event-free survival (28% vs 0%) and reduced relapse (44% vs 86%) vs TKI alone (all P less than .05).
Study details: Findings are from a retrospective analysis of 104 patients with CML-MBP receiving frontline treatment based on 4 different approaches, i.e., IC+TKI (n=20), HMA+TKI (n=20), TKI alone (n=56), or IC alone (n=8), between 2000 and 2019.
Disclosures: This study was supported by MD Anderson Cancer Center Support Grant and SPORE. NJ Short reported ties with various pharmaceutical companies. Other authors declared no competing interests.
Source: Saxena K et al. J Hematol Oncol. 2021 Jun 15. doi: 10.1186/s13045-021-01106-1 .