Management of refractory acute myeloid leukemia: re-induction therapy or straight to transplantation?

Publication/Presentation Date

3-1-2012

Abstract

Patients with primary resistant and relapsed acute myeloid leukemia (AML) are rarely cured without undergoing allogeneic stem cell transplantation. What is currently debated is whether a trial of re-induction chemotherapy prior to transplantation is beneficial. Data from multiple retrospective analyses have shown that pretreatment variables are useful in predicting response to salvage chemotherapy. For patients unlikely to respond, re-induction attempts may be detrimental, leading to added organ toxicity and possible increased tumor resistance. Allogeneic transplantation in the setting of active disease is the alternative strategy. Multiple studies have demonstrated the feasibility of this approach, but cure rates have been low with the use of traditional transplant approaches. Newer strategies employing allogeneic transplantation earlier in patients with relapsed or refractory AML, as well as the incorporation of novel and effective antileukemic agents into the transplant conditioning regimen, may lead to better outcomes.

Volume

7

Issue

1

First Page

74

Last Page

77

ISSN

1558-822X

Disciplines

Medicine and Health Sciences

PubMedID

21979876

Department(s)

Department of Medicine, Hematology-Medical Oncology Division, Lehigh Valley Topper Cancer Institute

Document Type

Article

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