Approach to patients with primary refractory acute myeloid leukemia

Abstract

Recent advances in understanding the pathogenesis of acute myeloid leukemia have not yet translated to a significantly improved outlook for patients with refractory disease. While there are several therapeutic options, outcomes remain poor and further studies are needed to identify and validate novel approaches.

Multicentre survey to explore current survival of patients with acute myeloid leukaemia who failed induction chemotherapy

“…This multicentre survey exploring the current outcome of 100 AML patients who failed induction chemotherapy (PIF‐AML) shows that, despite the improvement in supportive therapies and transplantation procedures, the prognosis of these patients is still extremely poor, with a 24‐month OS probability of 21% in our population. Therefore, the resistance to induction chemotherapy remains, even in the most recent years, an extremely unfavourable prognostic factor without a significant improvement in survival rate of these patients in the last years compared to the beginning of the last decade .…”

“…We know that a percentage of patients with acute myeloid leukaemia (AML), variable from 20 to 50%, according to risk and age, does not achieve a complete remission with induction chemotherapy. These cases are defined as primary induction failure (PIF) and always have represented an important therapeutic challenge .…”

“…Despite these important progress, the drugs that are used in the AML induction therapy have changed very little in the last years, while some new drugs have been tested in refractory patients, with variable preliminary results and toxicity profiles .…”

Total Body Irradiation without Chemotherapy as Conditioning for an Allogeneic Hematopoietic Cell Transplantation for Adult Acute Myeloid Leukemia

“…Attempts at reducing the morbidity and mortality of the conditioning regimen have focused on developing safer and more effective components [7, 15–19]. Modern TBI delivery systems combined with improved techniques and better supportive care have permitted safe dose escalation of the conditioning regimen [20, 21].…”

The best of times in hematologic malignancies

“…'. Orlowski et al [4] provide an approach for those patients with primary refractory AML. Remarkable insights into the pathogenesis of myeloid malignancies, drug development, and effective novel therapeutic strategies have contributed to unprecedented excitement.…”