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Review
. 2021 Mar 20;22(5):39.
doi: 10.1007/s11864-021-00841-4.

New Treatment Options for Older Patients with Acute Myeloid Leukemia

Kapil Saxena  1 , Marina Konopleva  2
Affiliations
Review

New Treatment Options for Older Patients with Acute Myeloid Leukemia

Kapil Saxena et al. Curr Treat Options Oncol. .

Abstract

The treatment of acute myeloid leukemia (AML) has evolved considerably over the past several years. Advances in the field have historically benefited younger patients; however, a growing understanding of the molecular basis of leukemogenesis has brought multiple targeted agents to the clinic for patients of all ages. These therapies have expanded the therapeutic landscape for elderly patients from more than best supportive care and low-intensity monotherapy. In general, we currently utilize a backbone regimen of a hypomethylating agent (HMA) or low-intensity chemotherapy with the BCL-2 inhibitor venetoclax for the majority of elderly patients with newly diagnosed AML. For patients with targetable mutations, we employ a doublet/triplet strategy of HMA + a targeted inhibitor +/- venetoclax, often in the context of a clinical trial. CPX-351 is reserved for patients with secondary or therapy-related AML. In this review, we will outline our approach to the treatment of elderly patients with AML, with particular emphasis on recently approved agents and emerging novel therapies.

Keywords: AML; Hypomethylating agent; Leukemia; Venetoclax.

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References

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Ferrara F, Barosi G, Venditti A, et al. Consensus-based definition of unfitness to intensive and non-intensive chemotherapy in acute myeloid leukemia: a project of SIE, SIES and GITMO group on a new tool for therapy decision making. Leukemia. 2013;27(5):997–9. https://doi.org/10.1038/leu.2012.303 . - DOI - PubMed
    1. Burnett AK, Russell NH, Hills RK, et al. Optimization of chemotherapy for younger patients with acute myeloid leukemia: results of the medical research council AML15 trial. J Clin Oncol. 2013;31(27):3360–8. https://doi.org/10.1200/JCO.2012.47.4874 . - DOI - PubMed
    1. Kantarjian HM, Thomas XG, Dmoszynska A, et al. Multicenter, randomized, open-label, phase III trial of decitabine versus patient choice, with physician advice, of either supportive care or low-dose cytarabine for the treatment of older patients with newly diagnosed acute myeloid leukemia. J Clin Oncol. 2012;30(21):2670–7. https://doi.org/10.1200/JCO.2011.38.9429 . - DOI - PubMed - PMC
    1. Dombret H, Seymour JF, Butrym A, et al. International phase 3 study of azacitidine vs conventional care regimens in older patients with newly diagnosed AML with >30% blasts. Blood. 2015;126(3):291–9. https://doi.org/10.1182/blood-2015-01-621664 . - DOI - PubMed - PMC
    1. Sekeres MA, Guyatt G, Abel G, et al. American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults. Blood Adv. 2020;4(15):3528–49. https://doi.org/10.1182/bloodadvances.2020001920 . - DOI - PubMed - PMC

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