Acute myeloid leukemia (AML) is a genetically heterogeneous malignancy comprised of various cytogenetic and molecular abnormalities that has notoriously been difficult to treat with an overall poor prognosis. For decades, treatment options were limited to either intensive chemotherapy with anthracycline and cytarabine-based regimens (7 + 3) or lower intensity regimens including hypomethylating agents or low dose cytarabine, followed by either allogeneic stem cell transplant or consolidation chemotherapy. Fortunately, with the influx of rapidly evolving molecular technologies and new genetic understanding, the treatment landscape for AML has dramatically changed. Advances in the formulation and delivery of 7 + 3 with liposomal cytarabine and daunorubicin (Vyxeos) have improved overall survival in secondary AML. Increased understanding of the genetic underpinnings of AML has led to targeting actionable mutations such as FLT3, IDH1/2 and TP53, and BCL2 or hedgehog pathways in more frail populations. Antibody drug conjugates have resurfaced in the AML landscape and there have been numerous advances utilizing immunotherapies including immune checkpoint inhibitors, antibody-drug conjugates, bispecific T cell engager antibodies, chimeric antigen receptor (CAR)-T therapy and the development of AML vaccines. While there are dozens of ongoing studies and new drugs in the pipeline, this paper serves as a review of the advances achieved in the treatment of AML in the last several years and the most promising future avenues of advancement

OBJECTIVES 1) To examine the effects of a month-long nap regimen using one of two durations (45 min, or 2 hr) on nighttime sleep and waking function in a group of healthy older subjects. 2) To assess the degree to which healthy older individuals are willing/able to adhere to such napping regimens. DESIGN Three laboratory sessions, with 2-week at-home recording interspersed, using a between-subjects approach. SETTING The study was conducted in the Laboratory of Human Chronobiology at Weill Cornell Medical College and in subjects’ homes. PARTICIPANTS Twenty-two healthy men and women aged 50–88 years (mean = 70y). MEASUREMENTS Polysomnography (sleep EEG), actigraphy, sleep diaries, neurobehavioral performance, sleep latency tests. RESULTS With the exception of compliance to the protocol, there were few differences between Short and Long nap conditions. Napping had no negative impact on subsequent nighttime sleep quality or duration, resulting in a significant increase in 24-hour sleep amounts. Such increased sleep was associated with enhanced cognitive performance, but had no impact on simple reaction time. Subjects were generally able to comply better with the 45-minute than the 2-hour nap regimen. CONCLUSION A month-long, daily nap regimen may enhance waking function without negatively impacting nighttime sleep. Using 2-hour naps in such a regimen is unlikely to meet with acceptable compliance; a regimen of daily 1-hour naps may be more desireable for both effectiveness and compliance.

The transformation of acute promyelocytic leukemia (APL) from an often fatal to highly curable cancer with long-term survival exceeding 90% is one of the greatest and most inspiring successes in oncology. A deeper understanding of the pathogenesis of APL heralded the introduction of highly effective therapies targeting the mutant protein that drives the disease, leading to the chemotherapy-free approach to cure almost all patients. In this review, we discuss the paradigm of treatment of APL in 2023, reinforce the high risk of early death without prompt initiation of treatment at first clinical suspicion, and dedicate a special focus to novel agents and future directions to improve cure rates and quality of life in patients affected by APL.