scholarly journals Advances in acute myeloid leukemia

BMJ ◽  
2021 ◽  
pp. n2026
Author(s):  
Laura F Newell ◽  
Rachel J Cook
Keyword(s):  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Standard Of Care ◽  
Patient Specific ◽  
Ongoing Research ◽  
Standard Of Care Treatment ◽  
New Treatment ◽  
Acute Myeloid

ABSTRACT Acute myeloid leukemia (AML) is an uncommon but potentially catastrophic diagnosis with historically high mortality rates. The standard of care treatment remained unchanged for decades; however, recent discoveries of molecular drivers of leukemogenesis and disease progression have led to novel therapies for AML. Ongoing research and clinical trials are actively seeking to personalize therapy by identifying molecular targets, discovering patient specific and disease specific risk factors, and identifying effective combinations of modalities and drugs. This review focuses on important updates in diagnostic and disease classifications that reflect new understanding of the biology of AML, its mutational heterogeneity, some important genetic and environmental risk factors, and new treatment options including cytotoxic chemotherapy, novel targeted agents, and cellular therapies.

scholarly journals Allogeneic hematopoietic cell transplantation for acute myeloid leukemia in older adults

Hematology ◽  
2014 ◽  
Vol 2014 (1) ◽  
pp. 21-33 ◽  
Author(s):  
Mohamed L. Sorror ◽  
Elihu Estey
Keyword(s):  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Assessment Tools ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Patient Specific ◽  
Acute Myeloid

Abstract Acute myeloid leukemia (AML) is primarily a disease of the elderly and the numbers of these patients are increasing. Patients ≥60 years of age continue to have poor prognosis. Preliminary results suggest benefit from reduced-intensity allogeneic hematopoietic cell transplantation (HCT) in selected patients 60-80 years of age. However, although patients in this age range comprise >50% of those with AML, they currently constitute only 17% of those offered HCT. In the absence of prospective randomized studies comparing HCT and chemotherapy, the decision to recommend HCT rests on retrospective analyses of the risks of relapse and nonrelapse mortality after each approach. There is strong evidence that pre-HCT comorbidities can predict HCT-related morbidity and mortality. Age alone does not appear predictive and, particularly if the risk of relapse with chemotherapy is high, should not be the sole basis for deciding against HCT. Use of geriatric assessment tools, inflammatory biomarkers, and genetic polymorphism data may further aid in predicting nonrelapse mortality after HCT. Disease status and pretreatment cytogenetics with FLT3-TID, NPM-1, and CEBP-α status are the main factors predicting relapse and these are likely to be supplemented by incorporation of other molecular markers and the level of minimal residual disease after chemotherapy. HLA-matched related and unrelated donor grafts seem preferable to those from other donor sources. Donor age is of no clear significance. Models combining comorbidities with AML risk factors are useful in risk assessment before HCT. In this chapter, we integrated information on AML-specific, HCT-specific, and patient-specific risk factors into a risk-adapted approach to guide decisions about HCT versus no HCT.

The Economic Costs of Acute Myeloid Leukemia in Sweden

1994 ◽  
Vol 10 (4) ◽  
pp. 683-694 ◽  
Author(s):  
Gunnel Ragnarson Tennvall ◽  
Ulf Persson ◽  
Bo Nilsson
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Cost Savings ◽  
Indirect Costs ◽  
Premature Mortality ◽  
Economic Costs ◽  
Potential Cost ◽  
New Treatment ◽  
Acute Myeloid

AbstractThe direct and indirect costs of acute myeloid leukemia were estimated for Sweden in 1989. The calculated total cost was SEK 460 million. Nearly half of the costs, or 1.7 million per patient diagnosed, were indirect costs due to premature mortality. Direct costs of relapses and indirect costs of mortality represent costs due to the absence of completely curable therapy. They also represent potential cost savings that could be ootained after introduction of new treatment options in the future.

scholarly journals Strategizing the Treatment Approach to Acute Myeloid Leukemia

2021 ◽  
pp. 1-6
Author(s):  
Laura Finn ◽  
Michael Lunski ◽  
Saikrishna Gadde ◽  
Matthew Alberti ◽  
Danny Markabawi ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Molecular Classification ◽  
Ongoing Research ◽  
Molecular Alterations ◽  
Treatment Regimens ◽  
New Treatments ◽  
Acute Myeloid

For decades acute myeloid leukemia, the primary acute leukemia affecting adults, had limited treatment options. Since 2017, we have seen discovery and development in cytogenetic and molecular classification of acute myeloid leukemia, improved understanding of cell signaling pathways, and development of new treatment for acute myeloid leukemia. These new treatments include novel combinations of agents and therapy targeting molecular alterations improving rates of remission and overall survival. Treatment discovery provides therapeutic opportunity to older patients and populations previously excluded from intense induction chemotherapy. In this review, we discuss the timing of first therapy, non-intense treatment regimens achieving remission, and new targets for directed therapy. We reference key clinical trials to expand our discussion of newly approved agents for acute myeloid leukemia. In this review, we highlight the discovery of treatment strategies to improve patient outcomes and ongoing research in leukemia.

Venetoclax-based combinations for the treatment of newly diagnosed acute myeloid leukemia

2021 ◽  
Author(s):  
Tamer A Othman ◽  
Tali Azenkot ◽  
Benjamin N Moskoff ◽  
Matthew E Tenold ◽  
Brian A Jonas
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Low Dose ◽  
Standard Of Care ◽  
Newly Diagnosed ◽  
Improved Outcomes ◽  
Standard Of Care Treatment ◽  
Unfit Patients ◽  
Low Dose Cytarabine ◽  
Acute Myeloid

Elderly and/or unfit patients with acute myeloid leukemia have historically been challenging to manage as they were ineligible for what was considered standard of care treatment with induction chemotherapy. The emergence of venetoclax with hypomethylating agents or low-dose cytarabine has substantially improved outcomes in the frontline setting with manageable toxicity. However, this regimen can be challenging to deliver given its differences from standard intensive chemotherapy. In this review, we summarize the landmark trials that established venetoclax-based combinations as a new standard of care for patients with acute myeloid leukemia not suitable for intense chemotherapy, provide practical clinical pearls for managing patients on these therapies, and offer a brief overview of modifications to these regimens under development to improve their efficacy and/or applicability.

Clinical Features and Recurrence Pattern of Perianal Abscess in Patients with Acute Myeloid Leukemia

2017 ◽  
Vol 138 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Hung Chang ◽  
Ming-Chung Kuo ◽  
Tzung-Chih Tang ◽  
Tung-Liang Lin ◽  
Jin-Hou Wu ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Gastrointestinal Tract ◽  
Stem Cell Transplantation ◽  
Myeloid Leukemia ◽  
Perianal Abscess ◽  
Standard Of Care ◽  
Recurrence Pattern ◽  
Surgical Interventions ◽  
Acute Myeloid

Introduction: Perianal abscess may develop during neutropenia periods in patients with acute myeloid leukemia (AML). The standard of care for perianal abscess in AML is unclear. Methods: We retrospectively collected patient data in our institute from 2009 to 2012. Results: Two hundred ninety-two patients with AML were analyzed. In total, 1,051 chemotherapy sessions were administered. Twenty-three patients experienced perianal abscess. Patients with perianal abscess were younger than those without (44 vs. 60 years, p < 0.0001). Perianal abscess developed in various phases of treatment and in the stem cell transplantation period. Twelve recurrences developed in 6 patients. Patients with a prior perianal abscess have a 10-fold risk of developing a subsequent abscess following further chemotherapy. The microbiology profile revealed that most pathogens were derived from the intestinal tracts, which was similar to the findings of previous studies. The 28-day mortality was 14.3% and the direct cause of death was not perianal abscess in any case. Surgical interventions had no impact on recurrence or survival. Conclusion: In patients with AML, perianal abscess results from gastrointestinal tract pathogens. Many patients do not require surgical interventions. The mortality is low but recurrence is common following subsequent chemotherapies. Therefore, awareness of recurrence is important for the timely management of perianal abscess in AML.

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