Acute myeloid leukemia with myelodysplasia-related changes (AML-MRC) and
treatment-related acutemyeloid leukemia (tAML) after chemotherapy or radiation therapy
for other neoplasms are associated with poor outcomes. CPX-351, a dual-drug liposomal
encapsulation of daunorubicin and cytarabine, has been shown to improve outcomes
in AML-MRC and tAML compared with standard 7+3 regimens. Here we report the
cases of four consecutive patients with AML-MRC or tAML who received CPX-351
as outpatient induction therapy immediately followed by allogeneic hematopoietic stem
cell transplantation (allo-HSCT). Two patients received allo-HSCT in remission (one in
complete remission and one in partial remission) and two patients received allo-HSCT
in aplasia (one at 11 days and one at 52 days after the start of induction therapy with
CPX-351). With a median follow-up of 188 days after allo-HSCT, all but one patient are
alive and two are in remission. Further studies will help define and expand the role of
CPX-351 in the treatment of AML-MRC and tAML, especially in patients expected to
undergo allo-HSCT