An Exclusive Interview with Sergio A. Giralt, MD
Chief, Adult Bone Marrow Transplant Service
Memorial SloanKettering Cancer Center
Professor of Medicine
Weill Cornell College of Medicine
New York, New York

Dr. Sergio A. Giralt, an internationally renowned expert in the treatment of hematological cancers, offers his comments on the 2012 Annual Meeting of the American Society of Clinical Oncology and the standard of care for hematologic malignancies.

Dr. Giralt comments on a co-authored presentation from ASCO 2012 entitled “Allogenic stem cell transplant (ASCT) as initial salvage for patients (pts) with acute myeloid leukemia (AML) refractory to high-dose cytarabine-based induction chemotherapy.” See below for news coverage of this presentation: Play
Dr. Giralt comments on the coverage of hematological malignancies at ASCO 2012: Play
Dr. Giralt comments on the impact of the hematological cancer coverage at ASCO 2012 on the practice of hematological oncology: Play

(CHICAGO, IL) – Initial salvage treatment with allogenic stem cell transplant (ASCT) is feasible and yields superior outcomes to salvage chemotherapy in acute myeloid leukemia (AML) patients who are refractory to high-dose cytarabine (HiDAC), according to a study presented at the 2012 American Society of Clinical Oncology Annual Meeting.

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Based on the dismal outcomes of AML patients who are refractory to HiDAC-based induction, a study was conducted to determine if ASCT as initial salvage treatment may be effective and potentially superior to repeat induction with combination chemotherapies, explained Naval Guastad Daver, MD, of Baylor College of Medicine, Houston, TX. The study was conducted together with colleagues from University of Texas MD Anderson Cancer Center, Houston.

Between 1995 and 2009, 1,597 AML patients were treated with HiDAC-based induction; within this group, 285 primary refractory patients were identified, 28 of whom underwent ASCT as initial salvage and were reviewed in the current study. The investigators reported that all patients were refractory to HiDAC-based induction, which was combined with an anthracycline in 16 patients (57%) and non-anthracycline in 12 patients (43%). Median time from induction to ASCT was 76 days (range: 28–184). Median bone-marrow blast and peripheral blast levels at ASCT were 28% (range: 3–82) and 4% (range: 0–41). Complete remission (CR) was achieved in 23 of 28 patients undergoing ASCT (CR=82%) with median time to CR of 31 days (range: 26–134); however, 12 patients relapsed (median time=5 months). Median overall survival (OS) was 15.7 months with ASCT vs. 3.2 months with salvage chemotherapy (P<0.001).

Dr. Daver and colleagues concluded that initial salvage with allogenic SCT is feasible and yields superior outcomes to salvage chemotherapy in primary HiDAC refractory AML patients.