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Updates in biology, classification, and management of acute myeloid leukemia with antecedent hematologic disorder and therapy related acute myeloid leukemia.
Leuk Res
September 2024
Division of Hematology and Oncology, Vanderbilt University School of Medicine and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA. Electronic address:
Article Synopsis
- Acute myeloid leukemia with antecedent hematologic disorder (AHD-AML) and therapy-related AML (t-AML) are diverse forms of leukemia associated with poor prognoses, often due to high-risk genetic alterations and prior cancer treatments.
- Standard treatment has historically involved intensive chemotherapy, but recent studies show that stem cell transplants may offer better long-term survival compared to just chemotherapy.
- Newer, less intensive treatment options, like the combination of hypomethylating agents with venetoclax, are showing promise, but resistance mechanisms and ongoing research into novel therapies are crucial for improving outcomes in these complex patient groups.
A phase I study of pevonedistat, azacitidine, and venetoclax in patients with relapsed/refractory acute myeloid leukemia.
Haematologica
September 2024
Division of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Azacitidine/venetoclax is an active regimen in patients with newly diagnosed acute myeloid leukemia (AML). However, primary or secondary resistance to azacitidine/venetoclax is an area of unmet need and overexpression of MCL1 is suggested to be a potential resistance mechanism. Pevonedistat inhibits MCL1 through activation of NOXA, and pevonedistat/azacitidine has previously shown activity in AML.
View Article and Find Full Text PDFHypomethylating Agents and Venetoclax for Acute Myeloid Leukemia Relapsed After Hematopoietic Stem Cell Transplant.
Clin Lymphoma Myeloma Leuk
June 2024
Department of Malignant Hematology, Moffitt Cancer Center and Research Institute, Tampa, FL. Electronic address:
Background: Hypomethylating agent + venetoclax is an effective frontline combination for acute myeloid leukemia, but its efficacy and safety in post-allogeneic hematopoietic cell transplant (alloHCT) relapse remain underexplored. Outcomes have been poor for this population, with no standard treatment.
Patients And Methods: We retrospectively analyzed 72 Ven-naïve patients who received hypomethylating agents + venetoclax at relapse following alloHCT and aimed to evaluate the rates of complete remission with or without hematologic recovery (CR/CRi) and minimal residual disease (MRD) negativity, CR/CRi duration, and overall survival.
Treatment of relapsed or refractory FLT-3 acute myelogenous leukemia with a triplet regimen of hypomethylating agent, venetoclax, and gilteritinib.
Leuk Lymphoma
March 2024
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA.
Article Synopsis
- Relapsed or refractory acute myeloid leukemia (AML) with FLT3 mutations is challenging to treat, and gilteritinib is a powerful oral medication that can improve survival rates in these cases.
- A study involving 22 patients showed that a combination treatment of gilteritinib with hypomethylating agents and venetoclax (HMA-VEN-GILT) achieved a 77.3% overall response rate, with significant numbers of patients showing partial responses.
- Follow-up indicated promising outcomes, including a 6-month overall survival rate of 84% and a 29.4% relapse rate, suggesting that HMA-VEN-GILT can serve as an effective treatment strategy and bridge to stem cell
Treatment of older adults with FLT3-mutated AML: Emerging paradigms and the role of frontline FLT3 inhibitors.
Blood Cancer J
September 2023
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
FLT3 is the most frequently mutated gene in acute myeloid leukemia (AML), with FLT3 internal tandem duplication (ITD) mutations being associated with a more aggressive clinical course. While two large, randomized clinical trials have shown a survival benefit with the frontline use of an oral FLT3 inhibitor (midostaurin or quizartinib) in patients with FLT3-mutated AML, the role of FLT3 inhibitors in older adults with newly diagnosed FLT3-mutated AML remains unclear. A definitive improvement in survival has not been observed in intensively treated patients over 60 years of age receiving frontline FLT3 inhibitors.
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