Background:

Mitoxantrone, a synthetic anthracycline agent, has demonstrated superior anti-leukemic efficacy in acute myelogenous leukemia (AML). Mitoxantrone hydrochloride liposome (Lipo-MIT) represents a novel nano-drug, showcasing promising pharmacokinetics and extending survival in animal studies when compared to standard mitoxantrone. Several studies have validated the anti-tumor effects and safety of Lipo-MIT. We review our experience with Lipo-MIT as a conditioning regimen in high-risk acute myelogenous leukemia (AML) who underwent allo-HSCT.

Method

Between October 2022 and April 2024, high-risk AML patients, achieving CR1 or CR2, applied for allo-HSCT were retrospectively enrolled in this study at Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC. Patients with HSCT were conditioned on the basis of Bu/Cy. Lipo-MIT was added at beginning of conditioning regimen (30mg/m2).

Result

This study included a total 17 high-risk AML patients achieving CR1 or CR2, with median age 42 years (ranged 18-60 years), received allo-HSCT (MSD-HSCT n=9, HID-HSCT n=7, MUD n=1). Five patients (5/17) had a diagnosis of extramedullary disease. Mucositis was the main reported regimen-related toxicity (10/17), most were well tolerated and only two were evaluated severe. No graft failure occurred. It is inspiring that all patients achieved hematology complete remission (CR) (100%) and 14/17 achieved MRD clearance on reconstitution day. The incidence of acute GVHD was 29.41% (5/17), and no severe aGVHD documented. With a median follow-up of 218（89-657）days, no relapse or deaths occurred among the patients.

Conclusion

The preliminary data demonstrated the efficacy and acceptable toxicity of Lipo-MIT containing regimen for high-risk AML patients.

Disclosures

No relevant conflicts of interest to declare.

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2024
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