A review of treatment options employed in relapsed/refractory AML

医学 髓系白血病 肿瘤科 耐火材料(行星科学) 临床试验 疾病 内科学 CD33 造血干细胞移植 挽救疗法 养生 美罗华 髓样 干细胞 化疗 川地34 淋巴瘤 生物 遗传学 天体生物学
作者
Mohamed Zakee Mohamed Jiffry,Robert Kloss,Mohammad Ahmed-Khan,Felipe Carmona-Pires,Nkechi Okam,Prabasha Weeraddana,Dinusha Dharmaratna,Mehndi Dandwani,Kayvon Moin
出处
期刊:Hematology [Informa]
卷期号:28 (1) 被引量:16
标识
DOI:10.1080/16078454.2023.2196482
摘要

Acute myeloid leukemia [AML] is a heterogenous group of primary hematopoietic neoplasms arising from myeloid precursor cells. Up to 50% of patients failed to achieve remission with initial therapy and go on to develop refractory AML. Whenever possible, enrollment in a clinical trial in view of the paucity of evidence surrounding a clearly superior treatment modality is recommended, and the therapy which provides the best chance for cure post remission is allogeneic hematopoietic stem cell transplantation [HCT], with much of everyday clinical decision-making in relapsed/refractory (R/R) AML surrounding the choice of the least toxic regimen that could achieve remission and enable prompt HCT.We discuss a variety of treatment modalities employed in the R/R AML setting beginning with traditional cytotoxic regimens. We then turn our attention to targeted therapies that have shown efficacy in specific patient populations such as the IDH inhibitors and FLT3 inhibitors and lastly, we turn our attention to immunotherapeutic agents employed in the R/R in the setting, such as CD33 inhibitors and bispecific antibodies.It appears increasingly clear that approaching AML as a homogenous disease entity is unsatisfactory in view of the variations in such disease factors as cytogenetic and molecular markers, age, and disease severity at presentation; all of which contribute significantly to heterogeneity of the disease. Moving forward, treating AML would likely require tailored therapy following advances in technology such as molecular profiling, drug sensitivity and resistance testing.
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