Older Patients with Acute Myeloid Leukemia Deserve Individualized Treatment

被引:20
|
作者
de Leeuw, David C. [1 ]
Ossenkoppele, Gert J. [1 ]
Janssen, Jeroen J. W. M. [1 ]
机构
[1] Amsterdam Univ Med Ctr, Locat VUmc, Dept Hematol, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands
关键词
Acute myeloid leukemia; Elderly; Fitness; Treatment; Intensive chemotherapy; Hematopoietic stem cell transplantation; Hypomethylating agents; Targeted therapy; FTL3; inhibitors; IDH inhibitors; Venetoclax; Enasidenib; Ivosidenib; Gilteritinib; Midostaurin; Gemutuzumab ozogamicin; Glasdegib; CPX-351; Vyxeos; CC-486; Azacitidine; Decitabine; HEMATOPOIETIC-CELL TRANSPLANTATION; HIGH-RISK; MYELODYSPLASTIC SYNDROME; INDUCTION CHEMOTHERAPY; INTENSIVE CHEMOTHERAPY; HYPOMETHYLATING AGENTS; GERIATRIC ASSESSMENT; COMORBIDITY INDEX; PREDICTS SURVIVAL; PHASE-2; TRIAL;
D O I
10.1007/s11912-022-01299-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of Review Treatment of elderly patients with acute myeloid leukemia is a known challenge for hematologists due to patient diversity, heterogeneous disease biology, and a rapidly evolving treatment landscape. Here, we highlight the importance of determining fitness, review the latest therapeutic developments, and discuss clinical scenarios to provide guidance on individualized treatment for older AML patients. Recent Findings Several factors, like age, performance status, and comorbidities, play a role in fitness and are associated with outcome. Comorbidity scoring systems and geriatric assessments are tools to help physicians select the most appropriate treatment for each patient. The addition of venetoclax, targeted therapy with IDH1/2 and FLT3 inhibitors, and enhanced formulas of existing drugs like CPX-351 and oral azacitidine have improved responses and outcomes. New drugs and combination therapies have increased the therapeutic options for elderly AML patients but determination of fitness and disease biology is essential to select patient-tailored treatments.
引用
收藏
页码:1387 / 1400
页数:14
相关论文
共 50 条
  • [21] The challenge of acute myeloid leukemia in older patients
    Sekeres, MA
    Stone, RM
    CURRENT OPINION IN ONCOLOGY, 2002, 14 (01) : 24 - 30
  • [22] Clofarabine in the treatment of acute myeloid leukemia in older adults
    Tiley, Stephen
    Claxton, David
    THERAPEUTIC ADVANCES IN HEMATOLOGY, 2013, 4 (01) : 5 - 13
  • [23] How to select older patients with acute myeloid leukemia fit for intensive treatment?
    Sustkova, Zuzana
    Semerad, Lukas
    Weinbergerova, Barbora
    Mayer, Jiri
    HEMATOLOGICAL ONCOLOGY, 2021, 39 (02) : 151 - 161
  • [24] Perceptions of prognosis and treatment risk in older patients with acute myeloid leukemia (AML).
    Nicholson, Showly
    Abel, Gregory A.
    Fathi, Amir Tahmasb
    Steensma, David P.
    LeBlanc, Thomas William
    DeAngelo, Daniel J.
    Wadleigh, Martha
    Hobbs, Gabriela
    Foster, Julia
    Brunner, Andrew Mark
    Amrein, Philip C.
    Stone, Richard M.
    Temel, Jennifer S.
    El-Jawahri, Areej
    JOURNAL OF CLINICAL ONCOLOGY, 2017, 35 (31)
  • [25] Treatment of acute myeloid leukemia in older patients: The EORTC-GIMEMA experience
    Amadori, S.
    Stasi, R.
    ANNALS OF HEMATOLOGY, 2006, 85 : 50 - 51
  • [26] Treatment challenges and outcomes of older patients with acute myeloid leukemia from India
    Singh, Suvir
    Lionel, Sharon
    Jain, Hasmukh
    Rajendra, Akhil
    Nayak, Lingaraj
    Selvarajan, Sushil
    Samuel, Prasanna
    Ahmed, Rayaz
    Aggarwal, Narendra
    Ds, Pavitra
    Byreddy, Poojitha
    John, Mjoseph
    Mishra, Kundan
    Kumar, Suman
    Paul, Mobin
    Abraham, Latha K.
    Kayal, Smita
    Ganesan, Prasanth
    Philip, Chepsy C.
    Das, Damodar
    Sreeraj, V
    Mehta, Prashant
    Pk, Jayachandran
    Raghavan, Vineetha
    Bala, Stalin Chowdary
    Bharath, Ram S.
    Majumdar, Swaratika
    Prakash, Om
    Barath, U.
    Bagal, Bhausaheb
    Abraham, Aby
    Kapoor, Rajan
    Bhurani, Dinesh
    Sengar, Manju
    Mathews, Vikram
    ANNALS OF HEMATOLOGY, 2024, : 4079 - 4088
  • [27] HOSPITALIZATIONS FOR OLDER PATIENTS WITH ACUTE MYELOID LEUKEMIA: INPATIENT TREATMENT IS INTENSIVE AND COSTLY
    Sacks, N.
    Cyr, P.
    Noone, J.
    Miller, D.
    Louie, A.
    VALUE IN HEALTH, 2016, 19 (03) : A246 - A246
  • [28] Novel drugs for older patients with acute myeloid leukemia
    G Montalban-Bravo
    G Garcia-Manero
    Leukemia, 2015, 29 : 760 - 769
  • [29] The artful management of older patients with acute myeloid leukemia
    Yang, Jay
    Schiffer, Charles A.
    EXPERT REVIEW OF HEMATOLOGY, 2016, 9 (05) : 425 - 432
  • [30] Defining Acute Myeloid Leukemia Ontogeny in Older Patients
    Melody, Megan
    Kuykendall, Andrew
    Sallman, David
    Al Ali, Najla
    Zhang, Ling
    Talati, Chetasi
    Padron, Eric
    Sweet, Kendra
    Extermann, Martine
    List, Alan
    Lancet, Jeffrey
    Komrokji, Rami
    CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, 2020, 20 (05): : 312 - 315