January 11, 2011 - AML Update: Treatment and Side Effects
- Blood and marrow tests used to diagnose acute myeloid leukemia (AML)
- Current and emerging treatment options
- Treatment side effects and strategies for managing side effects
- The role of clinical trials in the continuing improvement of AML treatment outcomes
Eric J. Feldman, M.D.
Professor of Medicine
Director, Hematological Malignancies
Weill Cornell Medical College
New York-Presbyterian Hospital
New York, NY
Dr. Feldman provides an overview of acute myeloid leukemia (AML), including how patients are treated and monitored during and after treatment. During the interactive segment of the program, Dr. Feldman answers audience questions.
- Patients who have chromosome abnormalities, for example, inversion 16 or translocation of 8;21, seem, on average, to do better with chemotherapy.
- Analysis from a review of 15 prospective trials that included more than 5,000 patients younger than 60 years who had sibling-matched donors and received standard allogeneic stem cell transplant conditioning treatment, showed that transplantation was beneficial in poor or intermediate risk patients (these patients are defined as somewhat chemotherapy-resistant), but there was no clear advantage of stem cell transplant compared to chemotherapy for the favorable or chemotherapy-sensitive group.
- A study from Sweden showed that routine treatment for older patients differed by patient age. In the 60 to 69 year age group, treatment was being offered, in the 70 to 79 year age group, half were offered treatment and the other half were not and in the over 79 age group, very few were offered treatment. The outcomes showed that many more patients who had received treatment, regardless of age, were alive. Therefore, the data suggests that treating older patients results in better outcomes.
- Receiving full intensity AML treatment has been shown to result in better outcomes than no treatment, but is associated with many side effects.
- Low intensity AML treatment is being studied using such drugs as azacitidine (Vidaza®) and decitabine (Dacogen®); similar drugs are being used for treatment in myelodysplastic syndromes.
- Reduced-intensity allogeneic stem cell transplantation (RIT) is emerging as an option for healthier older patients, whose leukemia may not be cured with traditional chemotherapy. RIT may be an option for patients up to the age of 75 and research indicates that outcomes for younger patients who have RIT may be as good as for younger patients who undergo standard allogeneic stem cell transplantation.
Questions from the AML Community
- Is there a cure for peripheral neuropathy resulting from treatment?
- How should I be monitored post-allogeneic stem cell transplantation?
- How often should I be monitored with bone marrow tests following AML treatment?
- How can I get tested for certain mutations to find out my risk of progression?
- What side effects should be expected when using Atgam®?
- What are the treatment options for relapsed acute promyelocytic leukemia?
- Are there any benefits to being treated with autologous stem cell transplantation?
- Are stem cell transplants done for AML patients older than 70 years of age?
- Are there any ways to stimulate the taste buds after getting mucositis following a stem cell transplant?
- What are the pros and cons for a stem cell transplant from donor blood or marrow cells or a transplant with stem cells from cord blood?
- How is imatinib (Gleevec®) used to treat AML patients?
- Would an identified intermediate-risk patient benefit from finding a donor for a stem cell transplant?
- How long does it take to type a stem cell donor?
- What are the long-term side effects of stem cell transplantation?
- Are there any ways to help problems with poor memory following AML treatment?
- What long-term effects should parents be aware of once their child has had a stem cell transplant to treat AML?
- What are the benefits of receiving maintenance azacitidine (Vidaza®)?
- What is the success rate for an older patient who had a transplant with cord blood stem cells?
Sponsors and Supporters
This program was sponsored by The Leukemia & Lymphoma Society and supported by a grant from Cephalon Oncology.