Page 1126 - Hematology_ Basic Principles and Practice ( PDFDrive )

992 Part VII Hematologic Malignancies

CONCLUSION
BOX 62.3 Treatment of Relapsed Acute Myeloid Leukemia
The treatment outcome for patients with acute myeloid leukemia (AML) Recent studies of the genetics and biology of AML have identified
who have suffered relapse of their disease is poor. On a recent inter- new therapeutics targets and have led to the development of novel
national trial for patients with refractory disease or in first relapse, the therapies, many of which are now in early-phase clinical trials. We
complete remission and overall survival rates were only 64% and 38%, hope that these efforts will lead to the development of more effective
respectively. For patients in second or later relapse, the outcome is and less toxic treatments in the near future. However, the evaluation
even worse, indicating that these patients are candidates for experi- of these treatment strategies will require collaboration between
mental approaches. Such approaches include the use of novel tyrosine cooperative groups to ensure that adequate numbers of patients to
kinase inhibitors, epigenetic therapy, and immunotherapy. Patients which each therapy is directed can be studied.
with FLT3-mutated relapsed AML should be enrolled on clinical trials
that incorporate second- or third-generation FLT3 inhibitors, such as
crenolanib, especially if they have previously received sorafenib. For
patients who do not have activating kinase mutations, epigenetic strate- SUGGESTED READINGS
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