The Cup Runneth Over: Treatment Strategies for Newly Diagnosed Acute Myeloid Leukemia

Cooperrider, Jennifer H.; Shukla, Navika; Nawas, Mariam T.; Patel, Anand

doi:10.1200/op.22.00342

Cited by 5 publications

(2 citation statements)

References 109 publications

(111 reference statements)

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“…Since 2017, there have been several novel therapies approved for use in acute myeloid leukemia (AML) that have led to significant evolution in the treatment approach in this disease. 12 , 13 These treatment approaches are often applied to patients with MPN-AP/BP despite being molecularly and morphologically distinct from de novo AML. 14 , 15 , 16 , 17 , 18 There are limited prospective data for the use of these therapies in MPN-AP/BP, and primarily real-world data have been analyzed to characterize their efficacy.…”

Section: Introductionmentioning

confidence: 99%

Treatment approach and outcomes of patients with accelerated/blast-phase myeloproliferative neoplasms in the current era

Patel,

Yoon,

Johnston

et al. 2024

Blood Advances

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Progression of myeloproliferative neoplasms (MPNs) to accelerated or blast-phase is associated with poor survival outcomes. Since 2017 there have been several therapies approved for use in acute myeloid leukemia (AML); these therapies have been incorporated into the management of accelerated/blast-phase MPNs (MPN-AP/BP). We performed a multi-center analysis to investigate outcomes of patients diagnosed with MPN-AP/BP in 2017 or later. Two-hundred two patients were identified; median overall survival (OS) was 0.86 years. We also analyzed patients based on first-line treatment; the three most common approaches were intensive chemotherapy (IC) (n=65), DNA methyltransferase inhibitor (DNMTi)-based regimens (n=65), and DNMTi + venetoclax (VEN)-based regimens (n=54). Median OS was not significantly different by treatment type. In addition, we evaluated response by 2017 European LeukemiaNet (ELN) AML criteria and 2012 MPN-BP criteria in an effort to understand the association of response with survival outcomes. We also analyzed outcomes in 65 patients that received allogeneic hematopoietic stem cell transplant (allo-HCT); median OS was 2.30 years from time of allo-HCT. Our study demonstrates that survival amongst patients with MPN-AP/BP is limited in the absence of allo-HCT even in the current era of therapeutics and underscores the urgent need for new agents and approaches.-

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Section: Introductionmentioning

confidence: 99%

Treatment approach and outcomes of patients with accelerated/blast-phase myeloproliferative neoplasms in the current era

Patel,

Yoon,

Johnston

et al. 2024

Blood Advances

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“…The recent evolution of targeted therapeutics in acute myeloid leukemia (AML) along with better understanding of disease biology and deeper assessment of post-treatment measurable residual disease (MRD) have improved outcomes of patients with this disease. 1 However, despite the attainment of deep remission in AML, i.e. a MRD-negative state, a majority of patients with non-acute promyelocytic leukemia AML relapse over time, with approximately 40% of MRD-negative patients relapsing within 5 years.…”

Section: Introductionmentioning

confidence: 99%

Maintenance therapy in acute myeloid leukemia: advances and controversies

2023

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The last decade has seen a steadfast progression in drug development in acute myeloid leukemia (AML) which have moved progressively towards genomics-based therapy. With these advancements, outcomes in AML have improved but remains far from satisfactory. An approach towards preventing relapse in AML is the use of a maintenance therapy in patients, after attaining remission. Allogeneic hematopoietic stem cell transplantation (HSCT) is an effective post-remission therapy that has been proven to reduce the risk of relapse. However, in patients who are ineligible for HSCT or have a high risk of relapse, other effective measures to prevent relapse are needed. There also exists a need for post HSCT maintenance to reduce relapse in high-risk subsets. Over the last 3 decades maintenance therapy in AML has evolved from the use of chemotherapeutic agents to more targeted therapies and better modulation of the immune system. Unfortunately, improvement in survival outcomes from these agents have not been consistently demonstrated in clinical trials. To derive the optimum benefit from maintenance therapy the time points of therapy initiation need to be defined and therapy selection must be precise with respect to the AML genetics and risk stratification, prior treatment exposure, transplant eligibility, expected toxicity and patient’s clinical profile and desires. The far-reaching goal is to facilitate patients with AML in remission to achieve a normal quality of life while improving remission duration and overall survival. The QUAZAR trial was a welcome step towards a safe maintenance drug with ease of administration and showed survival benefit but leaves many open issues for discussion. In this review we will discuss these issues, highlighting the development of AML maintenance therapies over the last 3 decades.

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Optimizing maintenance therapy in acute myeloid leukemia: where do we stand in the year 2024?

Alati,

Pitea,

Mico

et al. 2024

Expert Review of Hematology

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The Cup Runneth Over: Treatment Strategies for Newly Diagnosed Acute Myeloid Leukemia

Cited by 5 publications

References 109 publications

Treatment approach and outcomes of patients with accelerated/blast-phase myeloproliferative neoplasms in the current era

Treatment approach and outcomes of patients with accelerated/blast-phase myeloproliferative neoplasms in the current era

Maintenance therapy in acute myeloid leukemia: advances and controversies

Optimizing maintenance therapy in acute myeloid leukemia: where do we stand in the year 2024?

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