Evaluation of Fluoroquinolone Versus Other Antibiotic Prophylaxis Strategies in Adult Patients with AML Undergoing Induction Chemotherapy
acute myeloid leukemia, fluoroquinolone, prophylaxis, induction chemotherapy
Curative treatment of acute myeloid leukemia (AML) is based on one or two cycles of remission induction chemotherapy followed by consolidation chemotherapy or allogeneic hematopoietic cell transplantation (HCT) in those patients who enter complete remission (CR).
Conclusion Our data seem to confirm the value of FLAG-Ida in this setting and might suggest its best usage as bridge therapy for patients awaiting allotransplantation. Micro-Abstract Allotransplant is crucial for improving survival in refractory/first relapsed AML patients. An overall response was achieved in 48 patients (44% of the whole group) with FLAG-Ida chemotherapy approach. 24 of 48 responders underwent allotransplantation obtaining a median OS of 60 months.
Conclusion A single-institutional retrospective analysis found no significant differences in outcomes using GCLAC or CLAG for rrAML patients, though formal comparisons should be performed in a randomized clinical trial. The cost of GCLAC was higher than CLAG which should be considered when evaluating salvage chemotherapy options.
Conclusion CLAG plus IM was well tolerated, with encouraging signs of activity in patients with poor-risk AML.
Given the lack of standard salvage chemotherapy regimen for relapsed or refractory (RR) acute myeloid leukemia (AML), a phase 2 clinical study of cladribine, cytarabine, G-CSF (CLAG) regimen in combination with imatinib mesylate (IM) in patients with RR-AML was conducted at the Moffitt Cancer Center. Between August 2009 and April 2011, 38 patients were treated and the overall response rate was 37% with a median overall survival of 11.1 month. Among responders, 8/14 patients proceeded to allogeneic hematopoietic cell transplant. Overall, CLAG plus IM was well tolerated, with encouraging signs of activity in patients with poor-risk AML.
There is no standard salvage chemotherapy regimen for relapsed or refractory (RR) Acute Myeloid Leukemia (AML). Preclinical data suggested synergy in vitro between cytarabine and Imatinib Mesylate (IM) on AML cell growth inhibition. After demonstrating safety and feasibility with a phase I study, we conducted a phase 2 clinical study of Cladribine, Cytarabine, G-CSF (CLAG) regimen in combination with IM in patients with RR-AML.
tAML may occur as a complication of cytotoxic chemotherapy/radiation and is associated with a poor prognosis. CPX-351 is a dual-drug liposomal encapsulation that delivers a synergistic ratio of cytarabine:daunorubicin. In a phase 3 trial in older adults with untreated secondary AML (tAML or with antecedent MDS), CPX-351 significantly improved overall survival (OS) versus 7+3.
The use of chemotherapy can improve quality of life and survival in AML; however, many newly diagnosed patients do not receive any chemotherapy. Non-biological factors may influence the utilization of chemotherapy and can impact quality of care.
Acute myeloid leukemia (AML) is a clonal hematopoietic disorder characterized by a block in myeloid differentiation and aberrant proliferation of immature myeloid progenitors. Chemotherapy resistance is an inherent feature of self-renewing leukemia-initiating cells (LICs), and is what leads to disease relapse in the majority of AML patients.
Acute myeloid leukemia (AML) is the most common adult acute leukemia, and most patients die from their disease. Most older patients do not tolerate induction chemotherapy, and there are few effective therapies for relapsed/refractory disease. Novel approaches are needed. BCL-2 has been a promising target, and the recent clinical experience with venetoclax bring great promise. Here I summarize the rationale for and historical experience with targeting BCL-2, provide an overview of the venetoclax clinical data and speculate on its mechanism, and suggest future directions.