Salvage therapies for posttransplant relapse for myeloid malignancy (selected studies)
| First Author . | Year . | Regimen . | Total patients . | AML . | MDS . | DLI . | 2nd SCT . | %CR . | %ORR . | LFS or EFS . | OS/mOS . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HMA | |||||||||||
| Schroeder26 | 2013 | Aza+DLI | 30 | 28 | 2 | 22 (73%) | 5 (17%) | 23.0% | 30.0% | NA | mOS 117 days |
| Schroeder25 | 2015 | Aza+DLI | 154 | 124 | 28 | 105 (68%) | 19 (12.3%) | 27.0% | 33.0% | NA | 2 yr OS 29% |
| Rautenberg23 | 2020 | Aza+DLI | 151 | 90 | 49 | 105 (70%) | 17 (11%) | 41.0% | 46.0% | NA | 2 yr OS 38% |
| VEN based regimen | |||||||||||
| Aldoss31 | 2018 | HMA+VEN | 13 | 13 | 0 | NA | NA | NA | 46.2% | NA | 6 months 42.3% |
| Schuler30 | 2021 | HMA/VEN | 32 | 11 (34%) | 2 (6%) | 31.0% | 47.0% | NA | mOS 3.7 months | ||
| Amit29 | 2021 | VEN+various combinations | 22 | 22 | 0 | 22 (100%) | 18.0% | 50.0% | NA | mOS 6.1 months | |
| Joshi28 | 2021 | HMA/VEN | 29 | 19 | 10 | 0 | 3.0% | 28.0% | 38.0% | mLFS in responder, 259 days; mLFS nonresponder, 35 days | mOS 79 days; mOS 403 days in responder; mOS 55 days in nonresponder |
| Zucenka33 | 2021 | Venetoclax+LDAC+ actinomycin D (Active)+DLI vs FLAG-IDA | 29 | 29 | 0 | 10 in Active vs 7 in FLAG-IDA | 3% in Active vs 12% in FLAG-IDA | 70% in Active vs 34% FLAG-IDA | 75% in Active and 66% in FLAG-IDA | mEFS 7.7 months in ACTIVE; mEFS 2 months in FLAG-IDA | mOS 13.1 months in Active; mOS 5.1 months in FLAG-IDA |
| Zuanelli Brambilla34 | 2021 | CT 41.9%, HMA 52.7%, VEN 8.1% | 148 total (AML104/ MDS 44) | 104 | 44 | 17 (11.5%) | 28 (18.9%) | NA | NA | NA | mOS 6 months for all; 2 yr 44.9% in DLI/second SCT |
| Zhao35 | 2022 | Aza+VEN+DLI | 26 | 26 | 0 | 26 | 0 | 26.9% | 61.5% | mEFS 120 days | mOS 284 days |
| Intensive chemotherapy | |||||||||||
| Krakow27 | 2022 | Intensive CT | 175 | 175 | 0 | 13 | 13 | 36% | NA | mEFS 35 days; 1 yr EFS 15% | 1 yr OS 32%; 2 yr OS 18% |
| Pharmacological immunotherapy | |||||||||||
| Craddock50 | 2019 | Aza/LEN | 29 | 24 | 5 | 2 (7%) | 3 (10%) | 40% after cycle 3 | 24% in total, 47% after cycle 3 | NA | mOS 27 months in responder, 10 months in nonresponder |
| Schroeder51 | 2023 | LEN+ Aza+DLI | 59 | 23 | 24 | 34 | Not reported | 50% | 56% | Not reported | 1 yr 65% |
| Henden53 | 2019 | CT (FLAG)+ IFN-2α+DLI | 29 | 13 | 6 | 11 | 2 yr PFS 24% | 2 yr OS 31% | |||
| Adoptive cell immunotherapy | |||||||||||
| Lulla67 | 2021 | Donor-derived mLST | 8 | 7 | 1 transformed to AML | NA | 1 | 1/8% | 2/8% (1 CR and 1 PR) | Not reported | Not reported |
| Krakow68 | 2024 | HA-1 TCR transduced T-cells | 9 | 5 | 1 | NA | NA | 4/9% | 4/9% | Not reported | Not reported |
| First Author . | Year . | Regimen . | Total patients . | AML . | MDS . | DLI . | 2nd SCT . | %CR . | %ORR . | LFS or EFS . | OS/mOS . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HMA | |||||||||||
| Schroeder26 | 2013 | Aza+DLI | 30 | 28 | 2 | 22 (73%) | 5 (17%) | 23.0% | 30.0% | NA | mOS 117 days |
| Schroeder25 | 2015 | Aza+DLI | 154 | 124 | 28 | 105 (68%) | 19 (12.3%) | 27.0% | 33.0% | NA | 2 yr OS 29% |
| Rautenberg23 | 2020 | Aza+DLI | 151 | 90 | 49 | 105 (70%) | 17 (11%) | 41.0% | 46.0% | NA | 2 yr OS 38% |
| VEN based regimen | |||||||||||
| Aldoss31 | 2018 | HMA+VEN | 13 | 13 | 0 | NA | NA | NA | 46.2% | NA | 6 months 42.3% |
| Schuler30 | 2021 | HMA/VEN | 32 | 11 (34%) | 2 (6%) | 31.0% | 47.0% | NA | mOS 3.7 months | ||
| Amit29 | 2021 | VEN+various combinations | 22 | 22 | 0 | 22 (100%) | 18.0% | 50.0% | NA | mOS 6.1 months | |
| Joshi28 | 2021 | HMA/VEN | 29 | 19 | 10 | 0 | 3.0% | 28.0% | 38.0% | mLFS in responder, 259 days; mLFS nonresponder, 35 days | mOS 79 days; mOS 403 days in responder; mOS 55 days in nonresponder |
| Zucenka33 | 2021 | Venetoclax+LDAC+ actinomycin D (Active)+DLI vs FLAG-IDA | 29 | 29 | 0 | 10 in Active vs 7 in FLAG-IDA | 3% in Active vs 12% in FLAG-IDA | 70% in Active vs 34% FLAG-IDA | 75% in Active and 66% in FLAG-IDA | mEFS 7.7 months in ACTIVE; mEFS 2 months in FLAG-IDA | mOS 13.1 months in Active; mOS 5.1 months in FLAG-IDA |
| Zuanelli Brambilla34 | 2021 | CT 41.9%, HMA 52.7%, VEN 8.1% | 148 total (AML104/ MDS 44) | 104 | 44 | 17 (11.5%) | 28 (18.9%) | NA | NA | NA | mOS 6 months for all; 2 yr 44.9% in DLI/second SCT |
| Zhao35 | 2022 | Aza+VEN+DLI | 26 | 26 | 0 | 26 | 0 | 26.9% | 61.5% | mEFS 120 days | mOS 284 days |
| Intensive chemotherapy | |||||||||||
| Krakow27 | 2022 | Intensive CT | 175 | 175 | 0 | 13 | 13 | 36% | NA | mEFS 35 days; 1 yr EFS 15% | 1 yr OS 32%; 2 yr OS 18% |
| Pharmacological immunotherapy | |||||||||||
| Craddock50 | 2019 | Aza/LEN | 29 | 24 | 5 | 2 (7%) | 3 (10%) | 40% after cycle 3 | 24% in total, 47% after cycle 3 | NA | mOS 27 months in responder, 10 months in nonresponder |
| Schroeder51 | 2023 | LEN+ Aza+DLI | 59 | 23 | 24 | 34 | Not reported | 50% | 56% | Not reported | 1 yr 65% |
| Henden53 | 2019 | CT (FLAG)+ IFN-2α+DLI | 29 | 13 | 6 | 11 | 2 yr PFS 24% | 2 yr OS 31% | |||
| Adoptive cell immunotherapy | |||||||||||
| Lulla67 | 2021 | Donor-derived mLST | 8 | 7 | 1 transformed to AML | NA | 1 | 1/8% | 2/8% (1 CR and 1 PR) | Not reported | Not reported |
| Krakow68 | 2024 | HA-1 TCR transduced T-cells | 9 | 5 | 1 | NA | NA | 4/9% | 4/9% | Not reported | Not reported |
Aza, azacitinide; CT, chemotherapy; EFS, event-free survival; FLAG-IDA, Fludarabine, Cytarabine (Ara-C), Granulocyte-colony stimulating factor (G-CSF), and Idarubicin; LEN, lenalidomide; LFS, leukemia-free survival; mEFS, median event-free survival; mLST, multiple leukemia antigen–specific T-cell; mOS, median overall survival; NA, not reported; VEN, venetoclax.