Response Kinetics and Clinical Benefits of Nonintensive AML Therapies in the Absence of Morphologic Response

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, which is 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. Recently approved lower-intensity treatments for AML include enasidenib, ivosidenib, glasdegib, venetoclax, midostaurin, and gilteritinib, and additional promising agents are in later stages of clinical development. Noncytotoxic agents may result in slower kinetics of therapeutic activity compared to intensive regimens, and although they are generally better tolerated than intensive chemotherapy, bone marrow responses are less frequent and may take longer to achieve. Notably, newer therapies might have been considered ineffective had they been judged solely by 2003 International Working Group response criteria for AML, which were based on experience with intensive regimens in predominantly younger patients. Lower-intensity therapies may require several treatment cycles to induce responses, a...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research

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This study aimed to demonstrate the impact of LSCs on MRD induction day (14) and Day (28) on overall survival (OS) and disease free survival (DFS) as well as compare it to MRD status. 84 De novo adult AML patients tested for LSCs panels CD38/CD123/CD34/CD45, CD90/CD133/CD45/CD33 as well as different regular MRD panels. Day 14post induction, high expression of CD123% and CD133% had an adverse impact on both OS and DFS (p=0.004 &P=
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Purpose of review This review outlines the advancements that have been made in computational analysis for clinical flow cytometry data in hematological malignancies. Recent findings In recent years, computational analysis methods have been applied to clinical flow cytometry data of hematological malignancies with promising results. Most studies combined dimension reduction (principle component analysis) or clustering methods (FlowSOM, generalized mixture models) with machine learning classifiers (support vector machines, random forest). For diagnosis and classification of hematological malignancies, many studies have ...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: CANCER BIOLOGY: Edited by Pierre Hainaut and Sophie Park Source Type: research
ConclusionsIn the largest real-world study, we demonstrate an association between factors such as age, comorbidity and AML subtypes, and the use of multiagent chemotherapy. The use of multiagent chemotherapy was associated with improved OS, particularly among patients younger than 70 years, good-risk AML and those with low Charlson comorbidity score.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 2 January 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Fouad Kerbage, Riwa Sakr, Valerie Lapierre, Kamelia Alexandrova, Tereza Coman, Severine Leroux, Nolwenn Lucas, Sylvain Pilorge, Eric Solary, Jean-henri Bourhis, Cristina Castilla-LlorenteAbstractAllogeneic hematopoietic cell transplantation (AHCT) represents the only curative therapy for many hematological malignancies. The graft versus leukemia effect, driven by donor T cells, plays a major role in its curative potential. This effect is sometimes very evident when patients with acute myeloid leukemia and myelodysplasi...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
We analyzed US National Cancer Data Base of patients aged 60-79 years, who were diagnosed with acute myeloid leukemia (AML) between 2004-2014 (n=25,621). The use of multiagent versus single-agent chemotherapy was associated with a greater 1-year overall survival (43% vs. 28%), particularly for patients aged 60-69 years, those with good-risk AML or Charlson comorbidity score of 0-1.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
Publication date: Available online 30 January 2020Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Shyam A. Patel, Jonathan M. GerberAbstractFew diseases have been marked by a 40-year period of stagnation with regards to therapeutic advances and Food &Drug Administration (FDA) approvals, as has been the case for acute myeloid leukemia (AML). Cytarabine and anthracyclines were introduced for the treatment of AML in the 1970s, and in the ensuing four decades, the pharmacologic pipeline has experienced a standstill. The absence of FDA approvals in AML is not a reflection of the lack of understanding of the disease...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Few diseases have been marked by a 40-year period of stagnation with regards to therapeutic advances and Food&Drug Administration (FDA) approvals, as has been the case for acute myeloid leukemia (AML). Cytarabine and anthracyclines were introduced for the treatment of AML in the 1970s, and in the ensuing four decades, the pharmacologic pipeline has experienced a standstill. The absence of FDA approvals in AML is not a reflection of the lack of understanding of the disease biology. The field has seen major advances from the standpoint of stem cell biology and clonal evolution, and the field has also seen some therapeuti...
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Article Source Type: research
ConclusionT2B2F is associated with a higher incidence of acute GVHD compared to T1B2F. These results suggest that a lower dose-intensity of thiotepa and busulfan in the TBF regimen may yield better results in AML patients in complete remission.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionOur study did not find a statistically significant difference in the overall response rates or survival outcome measures for patients with AML and indeterminate day 14 bone marrow in the 2 treatment groups. Our findings question the utility of immediate reinduction chemotherapy and raise concern regarding overtreatment in this patient population. Larger studies investigating similar outcomes are warranted to validate our clinical findings.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
ConclusionsThe high ORR and reasonable duration of response could allow for potentially curative allogeneic hematopoietic cell transplantation for these patients with high-risk AML. Our initial data suggest that lenalidomide plus HMA is a promising approach for patients with AML with inv(3).
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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