We have previously shown that complete response (CR) rates and overall survival (OS) of patients with acute myeloid leukemia (AML) have improved since the 1980s. However, we have not previously evaluated how the length of first CR (CR1) has changed over this time period. To address this, we analyzed 1,247 patients age 65 or younger randomized to 7+3 arms from 5 SWOG studies: S8600 (n=530), S9031 (n=98), S9333 (n=57), S0106 (n=301), S1203 (n=261). We evaluated length of CR1 and survival after relapse from CR1 over the 4 decades these studies represent. Both length of CR1 and survival after relapse from CR1 have improved over the last four decades. The relative benefit associated with CR1 and the relative detriment associated with relapse have decreased over this period; while achieving CR1 and relapse from CR1 still have strong prognostic associations with outcomes, the magnitude of the association has decreased over time. Possible explanations for these patterns include higher CR rates with salvage therapies after relapse, more frequent use of hematopoietic cell transplant, and better supportive care.

中文翻译：

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过去四十年 7+3 诱导化疗治疗急性髓系白血病的疗效改善：SWOG 试验数据分析。

我们之前已经表明，自 1980 年代以来，急性髓系白血病 (AML) 患者的完全缓解 (CR) 率和总生存期 (OS) 有所改善。然而，我们之前没有评估第一个 CR (CR1) 的长度在这段时间内是如何变化的。为了解决这个问题，我们分析了来自 5 项 SWOG 研究的 1,247 名年龄在 65 岁或以下的患者随机分配到 7+3 组：S8600 (n=530)、S9031 (n=98)、S9333 (n=57)、S0106 (n=301) , S1203 (n=261)。我们评估了 CR1 的长度和这些研究代表的 4 十年内 CR1 复发后的存活率。在过去四十年中，CR1 的长度和 CR1 复发后的存活率都有所改善。在此期间，与 CR1 相关的相对益处和与复发相关的相对损害有所减少；虽然达到 CR1 和从 CR1 复发仍然与结果有很强的预后关联，但关联的程度随着时间的推移而降低。对这些模式的可能解释包括复发后挽救治疗的 CR 率更高、更频繁地使用造血细胞移植以及更好的支持治疗。