Safety and efficacy of CPX-351 in younger patients (<60 years old) with secondary acute myeloid leukemia

TO THE EDITOR:

Patients with secondary acute myeloid leukemia (s-AML), a category which includes AML with myelodysplasia-related changes (AML-MRC) and treatment-related AML (t-AML), have poor long-term outcomes following standard induction chemotherapy (“7+3”).^1,2 A previous population-based study demonstrated median survival of 6 to 7 months for patients with s-AML and 8 to 14 months for those with t-AML.¹ In 2017, a liposomal cytarabine and daunorubicin formulation (CPX-351) was Food and Drug Administration (FDA) approved for upfront treatment of s-AML based on a pivotal phase 3 trial demonstrating improved overall survival (OS) (9.56 vs 5.95 months; hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.52-0.9) and remission rates (complete remission [CR]/CR with incomplete count recovery [CRi]) (47.7% vs 33.3%; P = .016) in patients aged 60 to 75 years old than induction chemotherapy with “7+3.”³ The benefits from...