After more than 40 years with limited advances in treatment, recent approvals in acute myeloid leukemia (AML) include a new chemotherapy formulation and targeted therapies.1
However, further treatment options and advances in understanding the biology of AML still are needed.
For some patients with intermediate-risk or poor-risk AML, the best hope for long-term survival may be hematopoietic stem cell transplant, which is associated with significant improvement in overall survival and relapse-free survival in patients who received HSCT compared with those who did not receive HSCT.2 The rapid initiation of a donor search is a critical component in ensuring that eligible patients can undergo transplant.3
Minimal (or measurable) residual disease (MRD) refers to the number of leukemic cells beyond morphological detection that may persist after therapy.4 While MRD is monitored in other hematologic malignancies, clinical trials are still needed to understand the role of MRD in prognosis and treatment and determine the standardization of an MRD assay for AML. The validation of such a panel could help refine risk stratification, including the identification of risk factors associated with transplant therapy; assess treatment response; establish a deeper remission status; and guide postremission treatment strategies.4-6
While AML is most frequently diagnosed in people ≥65 years of age, patients of advanced age and/or those who are deemed unsuitable for intensive chemotherapy may have lower tolerance to cytotoxic agents, limiting treatment options.7,8 These patients may be candidates for therapies that are less intensive, including targeted therapeutic agents, low-intensity chemotherapy, and agents in clinical trials.9
As new therapeutic options become available and treatment strategies develop, future treatment options for some patients with AML may involve using 2 or more therapies with different mechanisms of action. Investigations into the clinical validity of certain combinations are ongoing.10