Observation Versus Immediate Reinduction for Acute Myeloid Leukemia Patients With Indeterminate Day 14 Bone Marrow Results

Effect of XRCC1 Arg399Gln Gene Polymorphism on Survival in Lymphoblastic Leukemia

“…Genetic analyses, which of all existing methods are the most profound and determine the essence of the gene relationship in the parameter of their influence not only on the life of a particular person, or patient but also on his future generation in the fact of procreation. Since the modified genome will be reflected on whole DNA systems, in the already existing modified level of further reproduction, in the form of gene modifications and changes (Jamy et al, 2020). genetic engineering have achieved great results, and a large number of the necessary equipment has been created in the accents of technical, biological, and chemical reagents, and this development continues to this day.…”

Advances in acute myeloid leukemia

“…Box 1 reviews classification schemes for AML. 13-17 19 Box 2 provides details about AML disease monitoring and "day 14" mid-induction bone marrow assessment, [20][21][22][23][24][25][26][27] and box 3 describes the nuances of monitoring for minimal/measurable residual disease (MRD). [28][29][30][31][32][33][34][35][36][37][38][39][40] "Risk factors" for AML Familial pre-disposition syndromes That families exist in which multiple members (in both childhood and adulthood) are affected by a myeloid malignancy has been long recognized.…”

“…○ Fitness of the patient at the time of the nadir marrow and ability to tolerate additional therapy ○ Likelihood of obtaining blast clearance based on cytogenetic and molecular risk stratification • The day 14-21 marrow biopsy remains a practice recommended by the NCCN, with determination of the need for additional therapy based on a combination of hypocellularity and blast clearance or as recommended by a clinical trial protocol ○ Clearance of blasts (<5% blasts in the marrow) at this early time point is prognostically favorable 20 21 ○ For patients with a partial response (blasts 5-19%), whether additional chemotherapy at the day 14 time point is able to improve outcomes is unclear [22][23][24] ○ In large cohorts of patients with acute myeloid leukemia on clinical trials, approximately 50% of patients with residual disease at day 14 undergo re-induction, suggesting that the bone marrow biopsy may be used as much for prognostication as for treatment decisions at day 14 and that strict adherence to guidelines risks overtreatment in this population [25][26][27][28]…”

Hypomethylating agent/venetoclax versus intensive chemotherapy in adults with relapsed or refractory acute myeloid leukaemia

“…Around 10%-40% of patients may not achieve CR to one round of an anthracycline-containing induction therapy. 10 The decision process to give those patients a second round of IC versus venetoclax-based therapy is not well defined. The only other study comparing HMA/Ven to IC for r/r AML utilized 10 days of Dec, instead of five, with the initial IC regimens already incorporating high-dose cytarabine plus an anthracycline with or without purine analogues.…”

“…The treatment of patients with AML, eligible for IC, has typically consisted of induction therapy with 7 + 3. Around 10%–40% of patients may not achieve CR to one round of an anthracycline‐containing induction therapy 10 . The decision process to give those patients a second round of IC versus venetoclax‐based therapy is not well defined.…”