Challenges in the diagnosis and treatment of secondary acute myeloid leukemia

Gert Ossenkoppele, Pau Montesinos

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Secondary AML (sAML), referring to AML arising after prior cytotoxic/radiation/immunosuppressive therapy (tAML) or an antecedent hematologic disorder, now primarily classified as AML with myelodysplasia-related changes (AML-MRC), accounts for 10%–30% of AML cases and is associated with a poor prognosis. sAML has historically been treated with intensive chemotherapy (eg, 7 + 3) or less aggressive regimens (eg, low-dose cytarabine or azacytidine for older/unfit patients); however, outcomes are typically poor, especially for older adults. Recently, CPX-351, a liposomal co-encapsulation of cytarabine and daunorubicin at a synergistic ratio, demonstrated improved front-line outcomes in older patients with high-risk/sAML. CPX-351 has been approved for adults with newly diagnosed tAML or AML-MRC and has an NCCN category 1 recommendation for induction therapy of patients aged >60 years with high-risk/sAML. Other novel therapies may also benefit certain sAML subgroups. Greater clarity around the optimal diagnosis and treatment of sAML patients is needed to improve outcomes in this high-risk subpopulation.
Original languageEnglish
Pages (from-to)6-13
JournalCritical Reviews in Oncology/Hematology
Volume138
DOIs
Publication statusPublished - 2019

Cite this

@article{b58567f23ec743b6a6cda6587d1e7a63,
title = "Challenges in the diagnosis and treatment of secondary acute myeloid leukemia",
abstract = "Secondary AML (sAML), referring to AML arising after prior cytotoxic/radiation/immunosuppressive therapy (tAML) or an antecedent hematologic disorder, now primarily classified as AML with myelodysplasia-related changes (AML-MRC), accounts for 10{\%}–30{\%} of AML cases and is associated with a poor prognosis. sAML has historically been treated with intensive chemotherapy (eg, 7 + 3) or less aggressive regimens (eg, low-dose cytarabine or azacytidine for older/unfit patients); however, outcomes are typically poor, especially for older adults. Recently, CPX-351, a liposomal co-encapsulation of cytarabine and daunorubicin at a synergistic ratio, demonstrated improved front-line outcomes in older patients with high-risk/sAML. CPX-351 has been approved for adults with newly diagnosed tAML or AML-MRC and has an NCCN category 1 recommendation for induction therapy of patients aged >60 years with high-risk/sAML. Other novel therapies may also benefit certain sAML subgroups. Greater clarity around the optimal diagnosis and treatment of sAML patients is needed to improve outcomes in this high-risk subpopulation.",
author = "Gert Ossenkoppele and Pau Montesinos",
year = "2019",
doi = "10.1016/j.critrevonc.2019.03.003",
language = "English",
volume = "138",
pages = "6--13",
journal = "Critical Reviews in Oncology / Hematology",
issn = "1040-8428",
publisher = "Elsevier Ireland Ltd",

}

Challenges in the diagnosis and treatment of secondary acute myeloid leukemia. / Ossenkoppele, Gert; Montesinos, Pau.

In: Critical Reviews in Oncology/Hematology, Vol. 138, 2019, p. 6-13.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Challenges in the diagnosis and treatment of secondary acute myeloid leukemia

AU - Ossenkoppele, Gert

AU - Montesinos, Pau

PY - 2019

Y1 - 2019

N2 - Secondary AML (sAML), referring to AML arising after prior cytotoxic/radiation/immunosuppressive therapy (tAML) or an antecedent hematologic disorder, now primarily classified as AML with myelodysplasia-related changes (AML-MRC), accounts for 10%–30% of AML cases and is associated with a poor prognosis. sAML has historically been treated with intensive chemotherapy (eg, 7 + 3) or less aggressive regimens (eg, low-dose cytarabine or azacytidine for older/unfit patients); however, outcomes are typically poor, especially for older adults. Recently, CPX-351, a liposomal co-encapsulation of cytarabine and daunorubicin at a synergistic ratio, demonstrated improved front-line outcomes in older patients with high-risk/sAML. CPX-351 has been approved for adults with newly diagnosed tAML or AML-MRC and has an NCCN category 1 recommendation for induction therapy of patients aged >60 years with high-risk/sAML. Other novel therapies may also benefit certain sAML subgroups. Greater clarity around the optimal diagnosis and treatment of sAML patients is needed to improve outcomes in this high-risk subpopulation.

AB - Secondary AML (sAML), referring to AML arising after prior cytotoxic/radiation/immunosuppressive therapy (tAML) or an antecedent hematologic disorder, now primarily classified as AML with myelodysplasia-related changes (AML-MRC), accounts for 10%–30% of AML cases and is associated with a poor prognosis. sAML has historically been treated with intensive chemotherapy (eg, 7 + 3) or less aggressive regimens (eg, low-dose cytarabine or azacytidine for older/unfit patients); however, outcomes are typically poor, especially for older adults. Recently, CPX-351, a liposomal co-encapsulation of cytarabine and daunorubicin at a synergistic ratio, demonstrated improved front-line outcomes in older patients with high-risk/sAML. CPX-351 has been approved for adults with newly diagnosed tAML or AML-MRC and has an NCCN category 1 recommendation for induction therapy of patients aged >60 years with high-risk/sAML. Other novel therapies may also benefit certain sAML subgroups. Greater clarity around the optimal diagnosis and treatment of sAML patients is needed to improve outcomes in this high-risk subpopulation.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85063752342&origin=inward

U2 - 10.1016/j.critrevonc.2019.03.003

DO - 10.1016/j.critrevonc.2019.03.003

M3 - Review article

VL - 138

SP - 6

EP - 13

JO - Critical Reviews in Oncology / Hematology

JF - Critical Reviews in Oncology / Hematology

SN - 1040-8428

ER -