Induction chemotherapy options for older patients with AML

During the AML Hub Steering Committee meeting, held on May 8, 2024, Gail Roboz chaired a discussion on induction chemotherapy options for older patients with acute myeloid leukemia (AML). The discussion featured Charles Craddock, Hwei-Fang Tien, Jeffrey Lancet, Jorge Sierra, and Lars Bullinger.

Roboz opens the discussion by inquiring about induction chemotherapy strategies for patients with AML over the age of 70 years. The focus centered on patient’s therapy goals and their eligibility for intensive therapy based on their fitness, disease biology, comorbidities, cytogenetics, MRD status, transplant eligibility, and feasibility of managing long-term outpatient regimens. The use of intensive chemotherapy in clinical practice versus clinical trials was also discussed, along with variations in drug approval and reimbursement across different countries. Roboz also raised questions about the first-line use of venetoclax in intensive chemotherapy and the preference for combination therapies over single-agent hypomethylating agents. The long duration of venetoclax treatment was another topic of interest, with optimism for potential future reductions.