Keypoints:
• Understanding the current standard of care for AML, including diagnosis and risk stratification.
• The importance of molecular profiling and how it influences treatment decisions.
• A detailed discussion on induction chemotherapy options, including the classic 7+3 regimen and CPX351 for therapy-related AML.
• Insights into the use of hypomethylating agents combined with venetoclax for patients unfit for intensive chemotherapy.
• The role of targeted therapies in both upfront treatment and relapsed/refractory settings.
• Key considerations for managing side effects, including cytopenias and infections.
In this episode we had the pleasure of speaking with Dr. Anand Patel, a hematologist and Medical Director of the Inpatient Leukemia Service at the University of Chicago. Our focus was on acute myeloid leukemia (AML), one of the most aggressive cancers we encounter in clinical practice.
We began by discussing the initial steps in diagnosing AML, including the importance of risk stratification and the necessary workup when a patient presents with high peripheral blast counts and B symptoms. Dr. Patel emphasized the significance of considering acute promyelocytic leukemia (APL) and the need for timely cytoreduction if leukostasis is present.
As we delved deeper into treatment paradigms, Dr. Patel outlined the current standard of care for AML, including the use of intensive chemotherapy regimens like 7+3 and CPX351 for therapy-related AML. He highlighted the role of targeted therapies, particularly for patients with specific mutations such as FLT3, and discussed the importance of molecular profiling both at diagnosis and during relapse.
For patients who are not candidates for intensive chemotherapy, we explored the use of hypomethylating agents combined with venetoclax, as well as the potential for triplet therapies. Dr. Patel cautioned about the increased myelosuppression associated with these combinations and the need for robust data to support their use.
We also touched on the significance of retesting molecular profiles in relapsed or refractory cases, as new actionable mutations can emerge. Dr. Patel shared insights on various targeted therapies available for these patients, including FLT3 inhibitors and menin inhibitors, and the ongoing research aimed at moving these therapies into earlier treatment settings.
In summary, this episode provided a comprehensive overview of the treatment landscape for AML, emphasizing the critical role of risk stratification, molecular profiling, and the evolving use of targeted therapies.
We hope our listeners find this discussion valuable as they navigate the complexities of AML treatment in their own practices. Thank you for tuning in to The Oncology Brothers!
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