We review here the state of the art of diagnosis and treatment of AML and provide insights into the emerging novel biomarkers and therapeutic agents that are anticipated to be useful for the implementation of personalized medicine in AML.
Acute Myeloid Leukemia
Individualizing Therapeutic Strategies in Acute Myeloid Leukemia: Moving Beyond the ‘One-Size-Fits-All’ Approach
We are ready to move beyond a “one-size-fits-all” approach in AML and join our colleagues treating other malignancies, such as lung cancer, in moving towards a personalized medicine approach.
Older patients with AML who are ineligible for intensive chemotherapy achieved improved overall survival when assigned to low-dose gemtuzumab ozogamicin.
A laboratory study found that the Hhex protein is overexpressed in acute myeloid leukemia cells and is necessary for their propagation but not for normal myelopoiesis.
An oral inhibitor of isocitrate dehydrogenase 2 (IDH2), AG-221, has shown activity and potentially durable remissions in patients with acute myeloid leukemia.
Using both clinical and molecular markers, researchers have created a simple prognostic index for patients with cytogenetically normal acute myeloid leukemia (AML).
New trial results show that a novel, oral metabolic inhibitor has demonstrated early activity in relapsed or refractory acute myeloid leukemia (AML), according to data presented at the annual meeting of the American Association of Cancer Research.
Sunesis Pharmaceuticals, Inc, announced that the US Food and Drug Administration has granted voreloxin orphan drug designation for the treatment of acute myeloid leukemia (AML). Sunesis is currently conducting two phase II clinical trials of voreloxin in AML: a single-agent study (REVEAL-1) in newly diagnosed elderly AML patients unlikely to benefit from standard induction chemotherapy and a study evaluating the drug in combination with cytarabine in relapsed/refractory AML.
Acute myeloid leukemia (AML) is a disease of the elderly, with the majority of patients diagnosed in their 6th and 7th decade of life. Older patients with AML are less likely to achieve complete remission after induction chemotherapy, and they suffer from higher rates of leukemia relapse compared to younger cohorts. Suboptimal outcomes are the result of adverse biologic characteristics of leukemia in the elderly, as well as the presence of medical comorbidities and patient or physician preferences as to initiating treatment. In addition, there is a distinct lack of randomized, prospective data to guide management decisions for the treatment of AML in the elderly. Patients who are over age 75, with poor performance status, multiple comorbidities, or poor prognostic features, should be considered for a clinical trial or palliative therapy. Elderly patients who are candidates for standard induction chemotherapy and achieve complete remission are unlikely to benefit from intensive postremission therapy and should be referred to a clinical trial when possible. Further prospective trials are needed to identify a tolerable, effective treatment regimen for older patients with AML.
This slide show features bone marrow biopsies showing acute myeloid leukemia (AML) cells replacing the bone marrow, and skin biopsies with AML infiltrating the dermis.