AML Treatment Improves Complete Remission, Total Effectiveness Rates

Findings from a meta-analysis assessing the efficacy of treatments for acute myelogenous leukemia (AML) indicate they can improve outcomes while reducing rates of adverse reactions.

The researchers of the analysis, which appeared recently in Annals of Palliative Medicine, argue that these treatments are worthy of clinical promotion based on their findings, which they say also provide evidence-based guidance for clinical practice.

“At present, drug therapy for acute myeloid leukemia is widely used in clinical practice, but the efficacy of drug therapy is still controversial, and there is no relevant systematic evaluation for the time being,” explained the researchers. “What is innovative about this study is that after a large number of relevant literature on various drug therapy regimens were collected, meta-analysis was used to compare the clinical efficacy of drugs in the treatment of acute myeloid leukemia published since the establishment of the database with other therapeutic methods, to provide a theoretical basis for drug treatment of acute myeloid leukemia.”

Across the 12 identified studies, spanning 2 decades, patients receiving AML treatments like fludara, cytarabine, aclacinomycin, and cladribine (the experimental group) were compared with other treatments, such as targeted therapy or immunotherapy (the control group). PubMed, Chinese Medical Citation Index, Medline, Embase, China National Knowledge Network, Wanfang, VIP and databases, and Google Scholar were searched.

According to the researchers, the accuracy of the dozen studies was high, no bias was identified, and the conclusions made were credible.

“The experimental participants were considerable different compared to controls [Z = 13.15; odds ratio [OR], 12.82; 95% CI, 8.77-18.76; P < .01],” commented the researchers. “Thus, the results showed that patients who received drug treatments had a higher complete remission rate than those who received other treatments. Additionally, drug treatments can substantially alleviate the pain of patients, and have obvious advantages.”

Of the 12 included articles, 8 provided data on total effectiveness rates across more than 600 patients. According to the researchers, the effectiveness rates across the groups was substantial (Z = 10.70; OR, 1.32, 95% CI, 7.32-17.89; P < .01), which the researchers say suggest that “drug treatment appears to substantially inhibit the proliferation of cancer cells and promote the overall apoptosis of cancerous lesions.”

Rates of adverse reactions were recorded in half of the studies, comprising 457 patients, and their prevalence was consistently higher among patients in the control group than in the experimental group, respectively, for oral ulcers (46 vs 21 cases), nausea and vomiting (41 vs 15 cases), infection (52 vs 46 cases), and elevated serum transaminase (53 vs 18 cases).

The authors noted several imitations to their findings; notably that their sample size was small and highly heterogeneous.

“Thus, sample size will be expanded to conduct clinical randomized controlled trials to verify these results,” they concluded.

Reference

Li H, Wang G, Wen X, Zhou L. Systematic review and meta-analysis of clinical efficacy of drug therapy for acute myelogenous leukemia. Ann Palliat Med. 2021;10(7):7884-7893