Treatment Strategies for Therapy-related Acute Myeloid Leukemia

Prajwal Dhakal; Bimatshu Pyakuryal; Prasun Pudasainee; Venkat Rajasurya; Krishna Gundabolu; Vijaya Raj Bhatt

doi:10.1016/j.clml.2019.12.007

Treatment Strategies for Therapy-related Acute Myeloid Leukemia

Prajwal Dhakal, Bimatshu Pyakuryal, Prasun Pudasainee, Venkat Rajasurya, Krishna Gundabolu, Vijaya Raj Bhatt

Research output: Contribution to journal › Review article › peer-review

10 Scopus citations

Abstract

Prospective evidence for management of therapy-related acute myeloid leukemia (t-AML) is limited, with evidence extrapolated from major AML trials. Optimal treatment is challenging and needs consideration of patient-specific, disease-specific, and therapy-specific factors. Clinical trials are recommended, especially for unfit patients or those with unfavorable cytogenetics or mutations. CPX-351 as an upfront intensive chemotherapy is preferred for fit patients; venetoclax with decitabine or azacitidine is an option for patients unfit for intensive chemotherapy. Hematopoietic cell transplant, the only curative option, should be offered to eligible patients with intermediate or unfavorable t-AML or patients with good-risk AML with minimal residual disease. Ongoing clinical trials focusing on treatment of t-AML, including targeted agents and immunotherapy, bode well for the future.

Original language	English (US)
Pages (from-to)	147-155
Number of pages	9
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	20
Issue number	3
DOIs	https://doi.org/10.1016/j.clml.2019.12.007
State	Published - Mar 2020

Keywords

CPX-351
Hematopoietic cell transplant
Unfavorable
Venetoclax
t-AML

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

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10.1016/j.clml.2019.12.007

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title = "Treatment Strategies for Therapy-related Acute Myeloid Leukemia",

abstract = "Prospective evidence for management of therapy-related acute myeloid leukemia (t-AML) is limited, with evidence extrapolated from major AML trials. Optimal treatment is challenging and needs consideration of patient-specific, disease-specific, and therapy-specific factors. Clinical trials are recommended, especially for unfit patients or those with unfavorable cytogenetics or mutations. CPX-351 as an upfront intensive chemotherapy is preferred for fit patients; venetoclax with decitabine or azacitidine is an option for patients unfit for intensive chemotherapy. Hematopoietic cell transplant, the only curative option, should be offered to eligible patients with intermediate or unfavorable t-AML or patients with good-risk AML with minimal residual disease. Ongoing clinical trials focusing on treatment of t-AML, including targeted agents and immunotherapy, bode well for the future.",

keywords = "CPX-351, Hematopoietic cell transplant, Unfavorable, Venetoclax, t-AML",

author = "Prajwal Dhakal and Bimatshu Pyakuryal and Prasun Pudasainee and Venkat Rajasurya and Krishna Gundabolu and Bhatt, {Vijaya Raj}",

note = "Funding Information: V.R. Bhatt reports serving as a consultant for Pfizer, CSL Behring, Agios, and Incyte, and has received research funding from Incyte, Tolero, and National Marrow Donor Program. The remaining authors have stated that they have no conflicts of interest. Funding Information: The project described was supported by the National Institute of General Medical Sciences, 1U54GM115458-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The project described was supported by the National Institute of General Medical Sciences , 1U54GM115458-01. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",

year = "2020",

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doi = "10.1016/j.clml.2019.12.007",

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AU - Dhakal, Prajwal

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AU - Rajasurya, Venkat

AU - Gundabolu, Krishna

AU - Bhatt, Vijaya Raj

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PY - 2020/3

Y1 - 2020/3

N2 - Prospective evidence for management of therapy-related acute myeloid leukemia (t-AML) is limited, with evidence extrapolated from major AML trials. Optimal treatment is challenging and needs consideration of patient-specific, disease-specific, and therapy-specific factors. Clinical trials are recommended, especially for unfit patients or those with unfavorable cytogenetics or mutations. CPX-351 as an upfront intensive chemotherapy is preferred for fit patients; venetoclax with decitabine or azacitidine is an option for patients unfit for intensive chemotherapy. Hematopoietic cell transplant, the only curative option, should be offered to eligible patients with intermediate or unfavorable t-AML or patients with good-risk AML with minimal residual disease. Ongoing clinical trials focusing on treatment of t-AML, including targeted agents and immunotherapy, bode well for the future.

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Treatment Strategies for Therapy-related Acute Myeloid Leukemia

Abstract

Keywords

ASJC Scopus subject areas

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