{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:24:17Z","timestamp":1793831057027,"version":"4.6.1"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n In the registration clinical trial 301 (NCT01696084), CPX\u2010351 has shown to be superior to conventional 3\u2009+\u20097 in secondary AML (s\u2010AML). However, the optimal duration of treatment, the best timing for allogeneic stem cell transplantation (allo\u2010HSCT), and the activity of CPX\u2010351 in specific s\u2010AML subgroups are unclear. To evaluate these aspects, a total of 513\u2009s\u2010AML patients (median age 65.6\u2009years, 19\u201379) treated with CPX\u2010351 were retrospectively analyzed. Complete remission (CR) rate after induction was 297\/513 (58%), increasing to 340\/513 (66%) after cycle 2. Among the 340 responding patients, 118 (34.7%), 137 (40.3%), and 85 (25%) received none, one, or two consolidation cycles of CPX\u2010351, respectively. Overall, 230\/513 patients (48.8%) received allo\u2010HSCT. Median follow up was 23.66\u2009months and median overall survival (OS) was 16.23\u2009months. Patients with mutated\n NPM<\/jats:italic>\n 1 or with ELN 2017 favorable risk (\n p<\/jats:italic>\n \u2009<\u20090.05) had a significantly longer OS (\n p<\/jats:italic>\n \u2009<\u20090.05). In a landmark analysis, receiving allo\u2010HSCT was associated with a longer survival (Median OS not reached vs. 16.3\u2009months for patients receiving or not receiving allo\u2010HSCT,\n p<\/jats:italic>\n \u2009<\u20090.05). Completion of all allowed CPX\u2010351\u2009cycles was beneficial only in patients not proceeding to transplant (\n p<\/jats:italic>\n \u2009<\u20090.05), whereas in transplanted patients additional CPX\u2010351\u2009cycles did not improve outcome. Our analysis suggests that also s\u2010AML patients with\n NPM1<\/jats:italic>\n mutations and those belonging to the ELN 2017 favorable risk category benefit from CPX\u2010351. In eligible patients, allo\u2010HSCT should be performed as soon as a CR is achieved, whereas patients not undergoing transplant benefit from a complete CPX\u2010351 schedule.\n <\/jats:p>","DOI":"10.1002\/ajh.70083","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T09:53:46Z","timestamp":1758707626000},"page":"2293-2304","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Real World Study on the Best\n CPX<\/scp>\n \u2010351 Treatment Duration and Timing for Allogeneic Stem Cell Transplantation"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3166-6078","authenticated-orcid":false,"given":"Fabio","family":"Guolo","sequence":"first","affiliation":[{"name":"University of Genoa Department of Internal Medicine (DiMI) Genoa Italy"},{"name":"IRCCS Ospedale Policlinico San Martino Dipartimento di Oncologia ed Ematologia Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-7202","authenticated-orcid":false,"given":"Luana","family":"Fianchi","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario \u201cA. 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