Details for patients with delayed and gradual achievement of CR
| Delayed CR . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Pt . | Tx . | Mutation . | Day∗ . | Blasts in BMB . | Cellularity† . | WBC 109/L . | ANC 109/L . | PLT 109/L . | Comments and outcomes . |
| 1 | 7+3 (Dauno 60) | R172-m | 28 | 35% | Hyper | 1.8 | 0.9 | 255 | Had been planned for salvage therapy which was delayed due to infection |
| 33 | 25% | Hyper/Normo | 4.1 | 3 | 370 | ||||
| 42 | 4% | Hyper/Normo | 5.4 | 4.5 | 557 | Plan for salvage therapy cancelled, patient continued to consolidation followed by transplant, died from aGVHD complications (while in CR) | |||
| 2 | 7+3 (Dauno 90) | R172-m | 14 | 50% | Hypo | 0.5 | 13 | ||
| 28 | 27% | Hypo | 1.5 | 0.8 | 112 | WBC with increased monocytosis | |||
| 53 | 4% | Normo | 6.1 | 5.2 | 236 | Continued to consolidation and transplant, achieved long-term CR | |||
| 3 | 7+3 (Dauno 60) | R172-m | 15 | 81% | Hypo | 0.2 | 12 | ||
| 34 | 8% | Normo/Hypo | 0.7 | 0.4 | 192 | ||||
| 45 | 3% | Normo/Hypo | 2 | 1 | 274 | Continued to consolidation and transplant, achieved long-term CR | |||
| 4 | 7+3 (Dauno 60) | R172-m | 15 | 70% | Hyper | 0.7 | 14 | ||
| 28 | 5% | Hyper/Normo | 1 | 0.3 | 28 | WBC with increased monocytosis | |||
| 43 | 4% | Normo | 4.5 | 2.4 | 54 | Continued to consolidation. Considered unfit for transplant, has continued with maintenance (oral azacitidine), remains in CR | |||
| 5 | 7+3+IDH2i | R140-m | 14 | 40% | Hypo | 0.2 | 24 | 4 | |
| 21 | 15% | Hypo | 0.5 | 5 | |||||
| 30 | 8% | Hypo | 1.1 | 0.2 | 51 | ||||
| 42 | 1% | Hypo | 2.1 | 1.2 | 104 | Continued to consolidation and transplant, achieved long-term CR | |||
| Delayed CR . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Pt . | Tx . | Mutation . | Day∗ . | Blasts in BMB . | Cellularity† . | WBC 109/L . | ANC 109/L . | PLT 109/L . | Comments and outcomes . |
| 1 | 7+3 (Dauno 60) | R172-m | 28 | 35% | Hyper | 1.8 | 0.9 | 255 | Had been planned for salvage therapy which was delayed due to infection |
| 33 | 25% | Hyper/Normo | 4.1 | 3 | 370 | ||||
| 42 | 4% | Hyper/Normo | 5.4 | 4.5 | 557 | Plan for salvage therapy cancelled, patient continued to consolidation followed by transplant, died from aGVHD complications (while in CR) | |||
| 2 | 7+3 (Dauno 90) | R172-m | 14 | 50% | Hypo | 0.5 | 13 | ||
| 28 | 27% | Hypo | 1.5 | 0.8 | 112 | WBC with increased monocytosis | |||
| 53 | 4% | Normo | 6.1 | 5.2 | 236 | Continued to consolidation and transplant, achieved long-term CR | |||
| 3 | 7+3 (Dauno 60) | R172-m | 15 | 81% | Hypo | 0.2 | 12 | ||
| 34 | 8% | Normo/Hypo | 0.7 | 0.4 | 192 | ||||
| 45 | 3% | Normo/Hypo | 2 | 1 | 274 | Continued to consolidation and transplant, achieved long-term CR | |||
| 4 | 7+3 (Dauno 60) | R172-m | 15 | 70% | Hyper | 0.7 | 14 | ||
| 28 | 5% | Hyper/Normo | 1 | 0.3 | 28 | WBC with increased monocytosis | |||
| 43 | 4% | Normo | 4.5 | 2.4 | 54 | Continued to consolidation. Considered unfit for transplant, has continued with maintenance (oral azacitidine), remains in CR | |||
| 5 | 7+3+IDH2i | R140-m | 14 | 40% | Hypo | 0.2 | 24 | 4 | |
| 21 | 15% | Hypo | 0.5 | 5 | |||||
| 30 | 8% | Hypo | 1.1 | 0.2 | 51 | ||||
| 42 | 1% | Hypo | 2.1 | 1.2 | 104 | Continued to consolidation and transplant, achieved long-term CR | |||
| Gradual blast reduction . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Pt. . | Tx . | Mutation . | Day∗ . | Blasts in BMB . | Cellularity† . | WBC 109/L . | ANC 109/L . | PLT 109/L . | Comments and outcomes . |
| 6 | 7+3 (Dauno 60) | R172-m | 15 | 70% | Hypo | 0.3 | 1 | ||
| 22 | 15% | Normo | 3 | 0.2 | 83 | Pathology notes: “Many monocytes with different maturation stages (from monoblasts to mature monocytes) are present.” | |||
| 37 | 4% | Normo | 4 | 2.2 | 451 | Continued to consolidation and transplant, achieved long-term CR | |||
| 7 | 7+3+IDH2i | R172-m | 13 | 75% | Hypo | 0.5 | 13 | ||
| 28 | 32% | Hyper | 2.6 | 1.2 | 437 | Suspected differentiation syndrome: by both pathology and clinical symptoms. Treated with steroids | |||
| 42 | 6% | Hyper | 39.6 | 28.5 | 304 | Pathology notes granulocytic hyperplasia, suspected differentiation syndrome. Not considered CR because of blast count of 6%, continued with enasidenib until achieving CR on day 89, continued to transplant, achieved long-term CR | |||
| 8 | 7+3 (Dauno 60) | R140-m | 14 | 13% | Hypo | 0.2 | 18 | ||
| 21 | 7% | Normo | 0.5 | 106 | |||||
| 37 | 4% | Normo/Hypo | 3.6 | 2.4 | 302 | Continued to consolidation and transplant, relapsed posttransplant | |||
| Gradual blast reduction . | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Pt. . | Tx . | Mutation . | Day∗ . | Blasts in BMB . | Cellularity† . | WBC 109/L . | ANC 109/L . | PLT 109/L . | Comments and outcomes . |
| 6 | 7+3 (Dauno 60) | R172-m | 15 | 70% | Hypo | 0.3 | 1 | ||
| 22 | 15% | Normo | 3 | 0.2 | 83 | Pathology notes: “Many monocytes with different maturation stages (from monoblasts to mature monocytes) are present.” | |||
| 37 | 4% | Normo | 4 | 2.2 | 451 | Continued to consolidation and transplant, achieved long-term CR | |||
| 7 | 7+3+IDH2i | R172-m | 13 | 75% | Hypo | 0.5 | 13 | ||
| 28 | 32% | Hyper | 2.6 | 1.2 | 437 | Suspected differentiation syndrome: by both pathology and clinical symptoms. Treated with steroids | |||
| 42 | 6% | Hyper | 39.6 | 28.5 | 304 | Pathology notes granulocytic hyperplasia, suspected differentiation syndrome. Not considered CR because of blast count of 6%, continued with enasidenib until achieving CR on day 89, continued to transplant, achieved long-term CR | |||
| 8 | 7+3 (Dauno 60) | R140-m | 14 | 13% | Hypo | 0.2 | 18 | ||
| 21 | 7% | Normo | 0.5 | 106 | |||||
| 37 | 4% | Normo/Hypo | 3.6 | 2.4 | 302 | Continued to consolidation and transplant, relapsed posttransplant | |||
aGVHD, acute graft versus host disease; ANC, absolute neutrophil count; delayed CR, CR after day 40 from induction with evidence of gradual blast reduction; gradual blast reduction, gradual blast reduction with CR before day 40 or after second-line therapy; IDH2i, enasidenib; PLT, platelet count; Pt, patient number; Tx, induction regimen; WBC, white blood cell count.
Day from induction initiation.
Cellularity grading (age-adjusted): Hyper, hypercellular BMB; Hyper/Normo, mildly hypercellular BMB; Normo, normocellular BMB; Normo/Hypo, mildly hypocellular BMB; Hypo, hypocellular BMB.