What Causes Treatment Failure in Acute Myeloid Leukemia with KMT2Ar?

Researchers of a study sought to discern causes of treatment failure and early mortality in acute myeloid leukemia (AML) with rearrangement of KMT2Ar outside of chemotherapy resistance and relapse. The results were presented at the 2022 American Society of Clinical Oncology Annual Meeting.

In this study, Daniel Nguyen and colleagues compared causes and rates of early mortality after induction between 172 adults with KMT2Ar AML and 522 age-matched patients with normal karyotype (NK) AML.

According to the results, the 30- and 60-day mortality rates in patients with KMT2Ar AML were notably higher compared to the cohort with NK AML, 10% and 15% in KMT2Ar AML versus 4% and 7% in NK AML. The investigators observed that respiratory failure was the most common contributing cause of death in KMT2Ar patients within 60 days. The researchers found that 42% of patients with KMT2Ar AML who died within 60 days were either diagnosed with or had high clinical suspicion for diffuse alveolar hemorrhage (DAH) that warranted empiric therapy.

“KMT2Ar AML is associated with higher early mortality and an increased risk of bleeding and coagulopathy compared with NK AML,” the researchers concluded.