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- Title
The leukemia strikes back: a review of pathogenesis and treatment of secondary AML.
- Authors
Cheung, Edna; Perissinotti, Anthony J.; Bixby, Dale L.; Burke, Patrick W.; Pettit, Kristen M.; Benitez, Lydia L.; Brown, Julia; Scappaticci, Gianni B.; Marini, Bernard L.
- Abstract
Secondary AML is associated with a disproportionately poor prognosis, consistently shown to exhibit inferior response rates, event-free survival, and overall survival in comparison with de novo AML. Secondary AML may arise from the evolution of an antecedent hematologic disorder, or it may arise as a complication of prior cytotoxic chemotherapy or radiation therapy in the case of therapy-related AML. Because of the high frequency of poor-risk cytogenetics and high-risk molecular features, such as alterations in TP53, leukemic clones are often inherently chemoresistant. Standard of care induction had long remained conventional 7 + 3 until its reformulation as CPX-351, recently FDA approved specifically for secondary AML. However, recent data also suggests relatively favorable outcomes with regimens based on high-dose cytarabine or hypomethylating agents. With several investigational agents being studied, the therapeutic landscape becomes even more complex, and the treatment approach involves patient-specific, disease-specific, and therapy-specific considerations.
- Subjects
ANTINEOPLASTIC agents; PROTEIN metabolism; ANIMALS; DAUNOMYCIN; GENETIC mutation; PROTEINS; ACUTE myeloid leukemia; CYTARABINE
- Publication
Annals of Hematology, 2019, Vol 98, Issue 3, p541
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-019-03606-0