Older Patients with Acute Myeloid Leukemia Deserve Individualized Treatment

被引:32
作者
de Leeuw, David C. [1 ]
Ossenkoppele, Gert J. [1 ]
Janssen, Jeroen J. W. M. [1 ]
机构
[1] Amsterdam Univ Med Ctr, Locat VUmc, Dept Hematol, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands
关键词
Acute myeloid leukemia; Elderly; Fitness; Treatment; Intensive chemotherapy; Hematopoietic stem cell transplantation; Hypomethylating agents; Targeted therapy; FTL3; inhibitors; IDH inhibitors; Venetoclax; Enasidenib; Ivosidenib; Gilteritinib; Midostaurin; Gemutuzumab ozogamicin; Glasdegib; CPX-351; Vyxeos; CC-486; Azacitidine; Decitabine; HEMATOPOIETIC-CELL TRANSPLANTATION; HIGH-RISK; MYELODYSPLASTIC SYNDROME; INDUCTION CHEMOTHERAPY; INTENSIVE CHEMOTHERAPY; HYPOMETHYLATING AGENTS; GERIATRIC ASSESSMENT; COMORBIDITY INDEX; PREDICTS SURVIVAL; PHASE-2; TRIAL;
D O I
10.1007/s11912-022-01299-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose of Review Treatment of elderly patients with acute myeloid leukemia is a known challenge for hematologists due to patient diversity, heterogeneous disease biology, and a rapidly evolving treatment landscape. Here, we highlight the importance of determining fitness, review the latest therapeutic developments, and discuss clinical scenarios to provide guidance on individualized treatment for older AML patients. Recent Findings Several factors, like age, performance status, and comorbidities, play a role in fitness and are associated with outcome. Comorbidity scoring systems and geriatric assessments are tools to help physicians select the most appropriate treatment for each patient. The addition of venetoclax, targeted therapy with IDH1/2 and FLT3 inhibitors, and enhanced formulas of existing drugs like CPX-351 and oral azacitidine have improved responses and outcomes. New drugs and combination therapies have increased the therapeutic options for elderly AML patients but determination of fitness and disease biology is essential to select patient-tailored treatments.
引用
收藏
页码:1387 / 1400
页数:14
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