Acute myeloid leukemia: 2021 update on risk‐stratification and management

Abstract

Management of AML involves choosing between purely palliative care, standard therapy and investigational therapy ("clinical trial"). Even most older patients likely benefit from treatment. Based on randomized trials CPX 351, midostaurin, gemtuzumab ozogamicin, and venetoclax, the latter three when combined with other drugs, should now be considered standard therapy. Knowledge of the likely results with these therapies is essential in deciding whether to recommend them or participate in a clinical trial, possibly including these drugs. Hence here, in the con

TIM-3 levels correlate with enhanced NK cell cytotoxicity and improved clinical outcome in AML patients

“…13,14 AML is a particularly challenging malignancy for which hematopoietic stem cell transplantation (HSCT) represents the primary therapeutic approach. 15 However, HSCT is curative only in a fraction of patients with AML, calling for the implementation of additional therapeutic strategies. 16,17 Epigenetic modifiers such as azacytidine and decitabine have been extensively investigated in HSCT-ineligible patients, with rather promising results.…”

Acute myeloid leukaemia in patients we judge as being older and/or unfit

“…Unfortunately, there were no differences in OS, because of the more frequent use of salvage therapy in the observation group, likely due to more cases of allo-SCT (11 vs 4). Salvage therapy improved survival in both observation and treatment groups [10,58]. A phase III, randomized, [60].…”

Experience with FLT3 Inhibitor Midostaurin in Newly Diagnosed Acute Myeloid Leukemia Patients

“…Standard criteria were used for response definitions. 7 Complete response neutrophil count over 1,000x10 9 /L, platelet count over 100,000x10 9 /L, Independence from erythrocyte suspension transfusion, blast rate below 5%, and complete maturation of all series (granulocyte, erythrocyte, and megakaryocyte) in bone marrow examination. 7 Of the 20 patients included in the study, 14 were male and 6 were female.…”

“…It is recommended to add FLT3 inhibitors along with standard remission induction therapy in patients with FLT3 mutation. 9 However, it takes a certain amount of time for the FLT3 mutation to result. For this reason, midostaurin treatment could be added not during remission induction but consolidation.…”

“…In addition to all these, when patients with FLT3 mutation enter remission, it is recommended to continue treatment with allogeneic hematopoietic stem cell transplantation. 6,9 We directed our patients who were in remission and had suitable donors for allogeneic hematopoietic stem cell transplantation. Although our study included a limited number of patients, it shows the significance of midostaurin treatment in newly diagnosed AML patients with FLT3 mutation.…”