sAML MANAGEMENT CHALLENGES

Video Duration: 2:48

((Dr. Jonathan Abbas))

I’m Dr. Jonathan Abbas, the director of the acute leukemia and blood cancer program with Tennessee Oncology in Nashville, Tennessee. I’ve been treating patients with blood cancers, specifically acute leukemia, for over a decade, and my center does over a 100 inductions a year in patients with AML, many of them with therapy-related AML and AML-MRC.

Patients with sAML have historically exhibited poor survival.

Survival and CR rates are lower in patients with secondary AML. Across different analyses, secondary AML has been seen to have a lower response rate and poor survival following intensive therapy.

In an analysis of 4,601 newly-diagnosed AML patients receiving curative-intent treatment from different trials ranging from 1987-2013, sAML was associated with a worse chance of achieving a CR.

As we’ve recently discussed, this group of patients of t-AML and AML-MRC represent some of the highest-risk patients we treat. The studies we just reviewed show that achieving a CR is very challenging in this patient population. Without achieving a CR, there is virtually no chance to cure any of these patients, and hence we need novel therapies designed to treat AML specifically for t-AML and AML-MRC.

The only curative treatment for patients with sAML is hematopoietic stem cell transplant therapy.

In order to give patients a chance of remission and ultimately prolonging survival, selection of an appropriate first-line treatment is important and must be considered carefully.

Chemotherapy is the foundation of treatment for adults with secondary AML, with a goal to remove as many leukemia cells from the body as possible to achieve remission and then proceed to stem cell transplant.

In my experience, achieving a CR in this high-risk AML population is imperative to giving them a shot at cure with stem cell transplant. Far too often, I have seen very healthy patients in their 60s and 70s, who would make excellent stem cell transplant candidates, but because they fail to achieve a first remission, they never have that opportunity.