The aml Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the aml Hub cannot guarantee the accuracy of translated content. The aml and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The AML Hub is an independent medical education platform, sponsored by Astellas, Daiichi Sankyo, Johnson & Johnson, Kura Oncology and Syndax, and has been supported through educational grants from Bristol Myers Squibb and the Hippocrate Conference Institute, an association of the Servier Group. The funders are allowed no direct influence on our content. The levels of sponsorship listed are reflective of the amount of funding given. View funders.
Now you can support HCPs in making informed decisions for their patients
Your contribution helps us continuously deliver expertly curated content to HCPs worldwide. You will also have the opportunity to make a content suggestion for consideration and receive updates on the impact contributions are making to our content.
Find out more
Create an account and access these new features:
Bookmark content to read later
Select your specific areas of interest
View aml content recommended for you
“How I treat” using maintenance approaches in patients with AML in clinical practice
|
A “how I treat” case series published in Blood by Roboz et al.1 discussed different clinical scenarios involving the use of maintenance treatments in patients with AML. |
| Key learnings |
| Case 1: A 64-year-old male with adverse-risk AML (ASXL1 and RUNX1 mutations) achieved remission after induction with idarubicin and cytarabine, but remained MRD+ by flow cytometry even after consolidation and could not undergo allo-HSCT due to his clinical condition. Treatment with oral azacitidine led to MRD− CR by Cycle 3. However, given his unfavorable risk profile, long-term remission with oral azacitidine was unlikely, so he subsequently underwent allo-HSCT. |
| Case 2: A fit 54-year-old female with NPM1 and SRSF2 co-mutated AML achieved MRD−remission after FLAG-Ida plus GO induction therapy. Despite eligibility, she was keen to avoid allo-HSCT. Consequently, she was treated with two cycles of high-dose cytarabine consolidation, followed by maintenance with oral azacitidine. |
| Case 3: A fit 45-year-old male with FLT3-ITD and IDH1-mutated AML underwent induction with 7+3 and gilteritinib, followed by consolidation with high-dose cytarabine and gilteritinib, but remained MRD+. He subsequently underwent allo-HSCT and was placed on gilteritinib maintenance. |
| Case 4: A 76-year-old female with congestive heart failure and a history of lung cancer was diagnosed with AML, with IDH2 and DNMT3A mutations detected by NGS. Since she had initially undergone low-intensity induction with Ven-Aza, her maintenance therapy included repeated cycles of Ven-Aza, with dose modifications post-remission. |
| The case series supports incorporating post-remission maintenance as part of SoC in AML. Further studies are needed to establish safe discontinuation of maintenance therapies and the routine use of high-sensitivity MRD assays in decision-making. |
Abbreviations: allo-HSCT, allogeneic hematopoietic stem cell transplantation; AML, acute myeloid leukemia; Aza, azacitidine; CR, complete remission; FLAG-Ida, fludarabine, idarubicin, cytarabine; ITD, internal tandem duplication; GO, gemtuzumab ozogamicin; MRD, measurable residual disease; NGS, next-generation sequencing; SoC, standard of care; Ven, venetoclax.
References
Please indicate your level of agreement with the following statements:
The content was clear and easy to understand
The content addressed the learning objectives
The content was relevant to my practice
I will change my clinical practice as a result of this content
