Defining Acute Myeloid Leukemia Ontogeny in Older Patients

AML in elderly patients (pts) is associated with poor outcomes and often arises from antecedent hematological disorders (AHD), classified as secondary AML (sAML). In order to validate the use of somatic mutations to determine AML ontogeny in the elderly population, we identified 178 elderly (>70yo) AML pts with NexGen Sequencing data. Pts were divided clinically into pAML or sAML based on prior history of AHD. Pts were then reclassified into 4 groups based on somatic mutations and cytogenetics as suggested by Lindsley et al: group 1 (pAML) with CBF rearrangements, 11q23/MLL, and NPM1 mutation (MT); group 2 (sAML) with SRSF2, SF3B1, U2AF1, ZRSR2, ASXL1, EZH2, BCOR, or STAG2 MT; group 3 with TP53 MT; and group 4 as not otherwise specified (NOS).
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research

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ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily pretreated patients. Adverse events were observed at a greater incidence than in the clinical trials. A wide heterogeneity of venetoclax dose escalation, multiagent combinations, and timing of initiation were identified and require investigation in subsequent clinical trials.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 26 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Eytan M. Stein, Courtney D. DiNardo, Daniel A. Pollyea, Andre C. SchuhAbstractThe ultimate goal of treatment for acute myeloid leukemia (AML) is to improve survival, and the best means of doing so is through the induction of morphologic remission, historically most reliably achieved with intensive chemotherapy regimens. Older patients with AML are less likely to be candidates for, or to benefit from, intensive chemotherapy. Patients deemed ineligible for intensive therapy may nevertheless benefit from lower intensity...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion: TA, FLAG and CLARA regimens are efficient and associated with acceptable toxicity in AML patients ineligible for "3+7" regimen due to cardiac comorbidities. However, long term outcome remains disappointing highlighting the need for the development of less toxic regimens.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
The ultimate goal of treatment for acute myeloid leukemia (AML) is to improve survival, and the best means of doing so is through the induction of morphologic remission, historically most reliably achieved with intensive chemotherapy regimens. Older patients with AML are less likely to be candidates for, or to benefit from, intensive chemotherapy. Patients deemed ineligible for intensive therapy may nevertheless benefit from lower intensity therapies and from newly available, targeted AML treatments.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Article Source Type: research
There is no consensual regimen for AML patients with contra-indication to receive anthracyclines (because of cardiac dysfunction or prior exposure to anthracyclines). Our study compared 3 anthracycline-free regimens currently used in France. It showed that, despite the poor outcome of these patients, Topotecan plus Cytarabine is effective and safe in these patients.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
Publication date: Available online 22 November 2019Source: Journal of Geriatric OncologyAuthor(s): Reena Jayani, Ashley Rosko, Rebecca Olin, Andrew ArtzAbstractHematopoietic cell transplant (HCT) is an important aspect of treatment for many hematologic malignancies. As cancer is a disease associated with aging, and hematologic malignancies are no exception, rates of autologous and allogeneic HCT utilization in older adults are on the rise. The most common indications for autologous HCT are multiple myeloma and lymphoma, and for allogenic HCT are acute myeloid leukemia and myelodysplastic syndrome. Older adults into their e...
Source: Journal of Geriatric Oncology - Category: Cancer & Oncology Source Type: research
Publication date: Available online 9 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Prajwal Dhakal, Elizabeth Lyden, Andrea Lee, Joel Michalski, Zaid S. Al-Kadhimi, Lori J. Maness, Krishna Gundabolu, Vijaya Raj BhattAbstractBackgroundThe role of obesity in prognosis of acute myeloid leukemia(AML) is debatable. Our retrospective study aimed to determine the effect of obesity on overall survival(OS) in AML.MethodsAML patients diagnosed at University of Nebraska Medical Center were divided into 3-groups based on body mass index (BMI): normal(18.5-25kg/m2) or underweight(
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 9 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Megan Melody, Andrew Kuykendall, David Sallman, Najla Al Ali, Ling Zhang, Chetasi Talati, Eric Padron, Kendra Sweet, Martine Extermann, Alan List, Jeffrey Lancet, Rami KomrokjiAbstractAML in elderly patients (pts) is associated with poor outcomes and often arises from antecedent hematological disorders (AHD), classified as secondary AML (sAML). In order to validate the use of somatic mutations to determine AML ontogeny in the elderly population, we identified 178 elderly (>70yo) AML pts with NexGen Sequencing data....
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 6 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Benjamin K. Tomlinson, Molly M. Gallogly, Donna M. Kane, Leland Metheny, Hillard M. Lazarus, Basem M. William, Michael D. Craig, Mark J. Levis, Brenda W. CooperAbstract:BackgroundMidostaurin, a multikinase inhibitor, is approved for treatment of FLT3 mutant acute myeloid leukemia (AML). A phase I study established that midostaurin 75 mg orally twice daily for 14 days with standard dose azacitidine was safe and tolerable in elderly AML. Herein, we report the phase II expansion cohort of previously untreated elderly or ...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
We aimed to determine the effect of obesity on overall survival(OS) in acute myeloid leukemia(AML). Total 314 patients were included in the study; 38% were obese. Actual body weight was used to dose chemotherapy in 92% of obese patients. On a multivariate analysis, obesity, compared to normal weight, conferred worse OS. OS was similar in obese and over-weight patients.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
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