Current Opinion in Hematology

Progress and strategies for patients with relapsed and refractory acute myeloid leukemia
Progress and strategies for patients with relapsed and refractory acute myeloid leukemia
Mark R. Litzow
Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
Article Language: TR
ABSTRACT
Purpose of review
The treatment of patients with refractory or relapsed acute myeloid leukemia remains challenging. Management of these patients must take into account patient and leukemiarelated factors in order to organize a comprehensive approach to treatment. Many new therapies are under study.
Recent findings
New molecular markers that represent mutations or gene overexpression have been identified including FMS-like tyrosine kinase-3 and nucleophosmin, which will enhance our ability to more accurately prognosticate for patients with acute myeloid leukemia. Monoclonal antibodies and peptide vaccination with leukemia-associated antigens bring the hope of increasing the remission and cure rates for patients with acute myeloid leukemia. The use of reduced-intensity conditioning blood or marrow transplantation is finding a broader role in the treatment of acute myeloid leukemia.
Summary
Patients with relapsed or refractory acute myeloid leukemia should be entered on clinical trials whenever feasible given the lack of consensus on the most effective treatment in this setting. Blood and marrow transplantation remains the only known curative therapy for these patients and the use of reduced-intensity conditioning blood or marrow transplantation offers the option of this approach to older and more infirm patients. Greater understanding of the biology of acute myeloid leukemia will provide new molecular targets of use in diagnosis, monitoring, and for the development of new, targeted therapies.

Keywords: blood or marrow transplantation, gene expression profiles, immunotherapy, molecular targets, reduced intensity conditioning

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30.03.2014

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