What Patient Factors Affect Acute Myeloid Leukemia Treatment Decisions?

The 3 main pillars to note when caring for patients with acute myeloid leukemia (AML) are patient condition, goals of care, and genomics, according to Daniel Peters, MD. When prompted about the current treatment landscape for AML, he highlighted those topics as the most important considerations when choosing a therapy. CancerNetwork® spoke with Peters during a site visit to Georgia Cancer Center.

Peters, an assistant professor of Hematology and Oncology in the Department of Medicine at the Medical College of Georgia of Augusta University and bone marrow transplant & cellular therapy faculty member at Georgia Cancer Center, stated that patient condition is relevant because comorbidities play a factor in treatment decision-making. A younger, more fit patient may be considered differently than an older patient with comorbidities such as heart failure or kidney dysfunction.

Additionally, a care provider must also be aware of what a patient hopes to accomplish with their treatment, whether that’s to be cured, to achieve the maximum disease-free survival, or to be as comfortable as possible. Each of these goals may influence what therapy a patient is given. Lastly, he discussed genomics, as patients with different cytogenetic or molecular abnormalities will react differently to various therapies.

Transcript:

There are 3 main pillars that I think about with patients who come in with newly diagnosed AML. The first and foremost is the patient's condition. What is their baseline level of health or functional status when they first come in with this really challenging hematologic malignancy? Is this a younger, fit patient who doesn’t have a lot of other medical problems or [as many] comorbidities as an older patient who has chronic medical conditions [such as] heart failure, liver or kidney dysfunction, etc? That’s the first thing in thinking about what kind of treatments they’re going to be eligible for. Alongside that, [we are] thinking about what our goals of care [are]. For patients, are we shooting for cure? Are we shooting for prolonged disease-free survival and keeping things at bay as long as possible? Or are we thinking about palliative/supportive care to make life as comfortable as possible for that period? The other really important pillar is based on genomics, so thinking about what type of cytogenetic or molecular abnormalities a patient has is obviously very critical in this day and age for guiding our frontline treatment for patients who have AML.