A randomized comparison of CPX-351 and FLAG-Ida in high-risk myelodysplastic syndrome: A subgroup analysis of UK NCRI AML19

Mehta, Priyanka, Skacel, Tomas, Faderl, Stefan, Murphy, Roderick, Park, Saemi, Thomas, Abin ORCID: https://orcid.org/0000-0002-8283-6762, Johnson, Sean and Legg, Alex 2026. A randomized comparison of CPX-351 and FLAG-Ida in high-risk myelodysplastic syndrome: A subgroup analysis of UK NCRI AML19. Leukemia Research Reports , 100609. 10.1016/j.lrr.2026.100609

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Abstract

CPX-351 improves outcomes for patients with secondary acute myeloid leukemia, but evidence of its use in high-risk myelodysplastic syndromes (MDS) is limited. This exploratory subgroup analysis of the randomized, controlled, open-label, phase 3 study—UK NCRI AML19—compared outcomes with CPX-351 versus FLAG-Ida in patients with high-risk MDS, to provide insights into the potential role of CPX-351 in this population. A total of 57 patients were included (CPX-351, n=34; FLAG-Ida, n=23). Compared with FLAG-Ida, CPX-351 prolonged median overall survival (OS; 17.8 vs 10.8 months) and median relapse-free survival (19.1 vs 7 months). Hematopoietic cell transplantation (HCT) rate was 59% and 52% for CPX-351 and FLAG-Ida, respectively. Median OS post-HCT was longer with CPX-351 than FLAG-Ida (22.3 vs 11.6 months). CPX-351 had a lower rate of serious adverse events than FLAG-Ida (9% vs 61%). These findings suggest that CPX-351 may be a promising frontline treatment option for high-risk MDS, and warrant confirmation in prospective studies.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Schools > Medicine Research Institutes & Centres > Centre for Trials Research (CNTRR)
Publisher:	Elsevier: Creative Commons
ISSN:	2213-0489
Date of First Compliant Deposit:	28 September 2026
Date of Acceptance:	11 September 2026
Last Modified:	28 Sep 2026 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/189819

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