Low-intensity treatment of hematological disorders
The invention relates to compositions and methods for treating patients with hematological proliferative disorders who are ineligible for treatment with standard intensive chemotherapy, using low intensity treatment with CPX-351, a liposomal composition of daunorubicin and cytarabine.
1. A treatment cycle for treating a hematological proliferative disorder in a subject ineligible for standard intensive chemotherapy (an ISICT subject), which treatment cycle comprises administering to the subject:
a pharmaceutical composition comprising CPX-351 at dosages of less than 32 units/m 2 per day on 3 days or less of a 28-day cycle, wherein CPX-351 is liposomally encapsulated cytarabine and daunorubicin at a fixed 5:1 molar ratio; and
venetoclax on days 2 to 21 of the 28-day cycle.
2. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is on 2 days at intervals of days 1 and 3 or days 1 and 5 or days 1 and 8.
3. The treatment cycle of claim 1 , wherein the dosages are less than 24 units/m 2 per day.
4. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is performed intravenously in less than 3 hours.
5. The treatment cycle of claim 1 , wherein the hematologic proliferative disorder is acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL) or acute promyelocytic leukemia (APL), myelodysplastic syndrome (MDS) or myeloproliferative neoplasm (MPN).
6. The treatment cycle of claim 1 , wherein the hematological proliferative disorder is acute myeloid leukemia (AML).
7. The treatment cycle of claim 1 , wherein the treatment cycle provides a greater therapeutic effect on the ISICT subject than that achieved with a 7+3 regimen on the ISICT subject.
8. The treatment cycle of claim 7 , wherein the greater therapeutic effect is measured as an increase in complete remission rate, prolongation of complete remission duration, prolongation of time to progression, or prolongation of survival of the subject.
9. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is on 2 days.
10. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is on 1 day.
11. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is on 2 days at intervals of days 1 and 3.
12. The treatment cycle of claim 1 , wherein the administering the pharmaceutical composition is performed intravenously in 90 minutes or less.
13. The treatment cycle of claim 1 , wherein the venetoclax is at a dosage of 400 mg.