Drs Gail Roboz and Roland Walter discuss measurable residual disease and relapse in patients with acute myeloid leukemia.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964539). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Bone Marrow Biopsy https://emedicine.medscape.com/article/197802-workup

Stem Cell Transplant https://emedicine.medscape.com/article/208954-overview

Donor Lymphocyte Infusions https://pubmed.ncbi.nlm.nih.gov/11941577/

Hypomethylating Agents https://emedicine.medscape.com/article/197802-treatment

FLT3, IDH2 https://emedicine.medscape.com/article/197802-workup#c9

Measurable Residual Disease https://decisionpoint.medscape.com/oncology/viewarticle/928279

2021 Update on MRD in Acute Myeloid Leukemia: A Consensus Document From the European LeukemiaNet MRD Working Party https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718623/

Measurable Residual Disease as a Biomarker in Acute Myeloid Leukemia: Theoretical and Practical Considerations https://www.nature.com/articles/s41375-021-01230-4

Core Binding Factor https://www.medscape.com/viewarticle/408452_4

Minimal Residual Disease Eradication With Epigenetic Therapy in Core Binding Factor Acute Myeloid Leukemia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779853/

Minimal Residual Disease Monitoring by Quantitative RT-PCR in Core Binding Factor AML Allows Risk Stratification and Predicts Relapse: Results of the United Kingdom MRC AML-15 Trial https://ashpublications.org/blood/article/120/14/2826/30510/Minimal-residual-disease-monitoring-by

MRD-Directed Risk Stratification Treatment May Improve Outcomes of t(8;21) AML in the First Complete Remission: Results From the AML05 Multicenter Trial https://pubmed.ncbi.nlm.nih.gov/23535063/

Drs Gail Roboz and Courtney DiNardo discuss methods of treating older patients with acute myeloid leukemia and managing unique toxicities.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/964537). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Acute Myeloid Leukemia https://emedicine.medscape.com/article/197802-overview

Cytarabine https://reference.medscape.com/drug/cytosar-u-depocyt-cytarabine-342089

Mylotarg (gemtuzumab ozogamicin) https://reference.medscape.com/drug/mylotarg-gemtuzumab-1000186

A Phase 3 Trial of Azacitidine Versus a Semi-Intensive Fludarabine and Cytarabine Schedule in Older Patients With Untreated Acute Myeloid Leukemia https://pubmed.ncbi.nlm.nih.gov/33626197/

Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia https://www.nejm.org/doi/full/10.1056/NEJMoa2012971

Ferrara Criteria https://decisionpoint.medscape.com/oncology/viewarticle/928810

Hydrea https://reference.medscape.com/drug/droxia-siklos-hydroxyurea-342100

Mucositis https://emedicine.medscape.com/article/1079570-overview

Azacytidine https://reference.medscape.com/drug/onureg-vidaza-azacitidine-342263

Decitabine https://reference.medscape.com/drug/dacogen-decitabine-342091

Venetoclax https://reference.medscape.com/drug/venclexta-venetoclax-1000078

Hydroxycarbamide in Combination With Azacitidine or Decitabine Is Antagonistic on DNA Methylation Inhibition https://pubmed.ncbi.nlm.nih.gov/17686055/

Drs Gail Roboz and Alexander Perl discuss adverse-risk acute myeloid leukemia.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964535). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

High Prognostic Impact of Flow Cytometric Minimal Residual Disease Detection in Acute Myeloid Leukemia: Data From the HOVON/SAKK AML 42A Study https://ascopubs.org/doi/10.1200/JCO.2012.45.9628

Diagnosis and Management of AML in Adults: 2017 ELN Recommendations from an International Expert Panel https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291965/

The Presence of a FLT3 Internal Tandem Duplication in Patients With Acute Myeloid Leukemia (AML) Adds Important Prognostic Information to Cytogenetic Risk Group and Response to the First Cycle of Chemotherapy: Analysis of 854 Patients From the United Kingdom Medical Research Council AML 10 and 12 trials https://www.sciencedirect.com/science/article/pii/S0006497120609351?via%3Dihub

Diagnostic and Therapeutic Pitfalls in NPM1-Mutated AML: Notes From the Field https://www.nature.com/articles/s41375-021-01222-4

Prognostic Impact of DNMT3A Mutation in Acute Myeloid Leukemia With Mutated NPM1 https://www.sciencedirect.com/science/article/pii/S2473952921005425

Midostaurin Plus Chemotherapy for Acute Myeloid Leukemia with a FLT3 Mutation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754190/pdf/nihms901401.pdf

Quizartinib With Standard of Care Chemotherapy and as Continuation Therapy in Patients With Newly Diagnosed FLT3-ITD (+) Acute Myeloid Leukemia (AML) (QuANTUM-First) https://clinicaltrials.gov/ct2/show/NCT02668653

A Review of FLT3 Inhibitors in Acute Myeloid Leukemia https://www.sciencedirect.com/science/article/abs/pii/S0268960X21001119?via%3Dihub

Abstract 591: Results of a Phase 2, Randomized, Double-Blind Study of Sorafenib Versus Placebo in Combination with Intensive Chemotherapy in Previously Untreated Patients with FLT3-ITD Acute Myeloid Leukemia (ALLG AMLM16) https://ash.confex.com/ash/2020/webprogram/Paper137334.html

AC220 Is a Uniquely Potent and Selective Inhibitor of FLT3 for the Treatment of Acute Myeloid Leukemia (AML) https://news.unboundmedicine.com/medline/citation/19654408/AC220_is_a_uniquely_potent_and_selective_inhibitor_of_FLT3_for_the_treatment_of_acute_myeloid_leukemia__AML__

Daiichi Waits on FDA as AML Drug Quizartinib Approved in Japan https://pharmaphorum.com/news/daiichi-waits-on-fda-as-aml-drug-quizartinib-approved-in-japan/

FDA Declines to Approve Quizartinib for FLT3-Mutated Acute Myeloid Leukemia https://ashpublications.org/ashclinicalnews/news/4584/FDA-Declines-to-Approve-Quizartinib-for-FLT3

Safety and Preliminary Efficacy of Venetoclax With Decitabine or Azacitidine in Elderly Patients With Previously Untreated Acute Myeloid Leukaemia: A Non-randomised, Open-Label, Phase 1b Study https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30010-X/fulltext

Triplet Therapy With Venetoclax, FLT3 Inhibitor and Decitabine for FLT3-Mutated Acute Myeloid Leukemia https://www.nature.com/articles/s41408-021-00410-w

Impact of Venetoclax and Azacitidine in Treatment-Naïve Patients With Acute Myeloid Leukemia and IDH1/2 Mutations https://aacrjournals.org/clincancerres/article/doi/10.1158/1078-0432.CCR-21-3467/677977/Impact-of-Venetoclax-and-Azacitidine-in-Treatment

Abstract 32: Comparing Outcomes Between Liposomal Daunorubicin/Cytarabine (CPX-351) and HMA+Venetoclax As Frontline Therapy in Acute Myeloid Leukemia https://ash.confex.com/ash/2021/webprogram/Paper145947.html

Abstract 795: Real World Survival Outcomes of CPX-351 Versus Venetoclax and Azacitadine for Initial Therapy in Adult Acute Myeloid Leukemia https://ash.confex.com/ash/2021/webprogram/Paper149158.html

Drs Gail Roboz and Pinkal Desai discuss intermediate-risk acute myeloid leukemia.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964532). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.

Resources

Diagnosis and Management of Acute Myeloid Leukemia in Adults: Recommendations From an International Expert Panel, on Behalf of the European LeukemiaNet https://www.sciencedirect.com/science/article/pii/S0006497120493048?via%3Dihub

Acute Myeloid Leukemia: 2019 Update on Risk-Stratification and Management https://onlinelibrary.wiley.com/doi/full/10.1002/ajh.25214

Gemtuzumab Ozogamicin for De Novo Acute Myeloid Leukemia: Final Efficacy and Safety Updates From the Open-Label, Phase III ALFA-0701 Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6312010/

Midostaurin Plus Chemotherapy for Acute Myeloid Leukemia With a FLT3 Mutation https://www.nejm.org/doi/full/10.1056/nejmoa1614359

Allogeneic Hematopoietic Stem Cells Transplantation Improves the Survival of Intermediate-Risk Acute Myeloid Leukemia Patients Aged Less Than 60 Years https://link.springer.com/article/10.1007/s00277-018-3584-2

Minimal/Measurable Residual Disease in AML: A Consensus Document From the European LeukemiaNet MRD Working Party https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865231/?report=printable

Prevention, Recognition, and Management of Adverse Events Associated With Gemtuzumab Ozogamicin Use in Acute Myeloid Leukemia https://jhoonline.biomedcentral.com/articles/10.1186/s13045-020-00975-2

Effective Menin Inhibitor-Based Combinations Against AML With MLL Rearrangement or NPM1 Mutation (NPM1c) https://www.nature.com/articles/s41408-021-00603-3

First in Human Study of KO-539 in Relapsed or Refractory Acute Myeloid Leukemia https://www.clinicaltrials.gov/ct2/show/NCT04067336

A Study of JNJ-75276617 in Participants With Acute Leukemia https://clinicaltrials.gov/ct2/show/NCT04811560

Study of BMF-219, in Adult Patients With Acute Leukemia, Diffuse Large B-Cell Lymphoma and Multiple Myeloma https://clinicaltrials.gov/ct2/show/NCT05153330

A Study of DSP-5336 in Relapsed/Refractory AML/ALL With or Without MLL Rearrangement or NPM1 Mutation https://clinicaltrials.gov/ct2/show/NCT04988555

Efficacy of Oral Azacitidine Plus Best Supportive Care as Maintenance Therapy in Subjects With Acute Myeloid Leukemia (AML) in Complete Remission (QUAZAR AML-001) https://clinicaltrials.gov/ct2/show/NCT01757535

Oral Azacitidine Maintenance Therapy for Acute Myeloid Leukemia in First Remission https://www.nejm.org/doi/10.1056/NEJMoa2004444

Azacitidine and Venetoclax in Previously Untreated Acute Myeloid Leukemia https://www.nejm.org/doi/full/10.1056/NEJMoa2012971

Venetoclax Plus LDAC for Newly Diagnosed AML Ineligible for Intensive Chemotherapy: A Phase 3 Randomized Placebo-Controlled Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290090/

Glasdegib Prescribing Information https://labeling.pfizer.com/ShowLabeling.aspx?format=PDF&id=11336

Drs Gail Roboz and Gautam Borthakur discuss good-risk acute myeloid leukemia.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964531). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Diagnosis and Management of AML in Adults: 2017 ELN Recommendations From an International Expert Panel https://ashpublications.org/blood/article/129/4/424/36196/Diagnosis-and-management-of-AML-in-adults-2017-ELN

Refinement of Cytogenetic Classification in Acute Myeloid Leukemia: Determination of Prognostic Significance of Rare Recurring Chromosomal Abnormalities Among 5876 Younger Adult Patients Treated in the United Kingdom Medical Research Council Trials https://ashpublications.org/blood/article/116/3/354/27618/Refinement-of-cytogenetic-classification-in-acute

Gemtuzumab Ozogamicin in NPM1-Mutated Acute Myeloid Leukemia: Early Results From the Prospective Randomized AMLSG 09-09 Phase III Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7030890/

2021 Update on MRD in Acute Myeloid Leukemia: A Consensus Document From the European LeukemiaNet MRD Working Party https://pubmed.ncbi.nlm.nih.gov/34724563/

Venetoclax Plus Intensive Chemotherapy With Cladribine, Idarubicin, and Cytarabine in Patients With Newly Diagnosed Acute Myeloid Leukaemia or High-Risk Myelodysplastic Syndrome: A Cohort From a Single-Centre, Single-Arm, Phase 2 Trial https://pubmed.ncbi.nlm.nih.gov/34329576/

Core Binding Factor Acute Myelogenous Leukemia-2021 Treatment Algorithm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209225/

Oral Azacitidine Maintenance Therapy for Acute Myeloid Leukemia in First Remission https://www.nejm.org/doi/full/10.1056/NEJMoa2004444

NCCN Guidelines Version 1.2022: Acute Myeloid Leukemia, Acute Promyelocytic Leukemia, Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1411

Drs Gail Roboz and Farhad Ravandi discuss acute promyelocytic leukemia, a relatively uncommon subset of acute myeloid leukemia.

Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/964529). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

High Prevalence of Obesity in Acute Promyelocytic Leukemia (APL): Implications for Differentiating Agents in APL and Metabolic Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573402/pdf/10.1177_2040620711408490.pdf

High Frequency of Acute Promyelocytic Leukemia Among Latinos With Acute Myeloid Leukemia https://www.sciencedirect.com/science/article/pii/S0006497120662218?via%3Dihub

Improved Outcomes With Retinoic Acid and Arsenic Trioxide Compared With Retinoic Acid and Chemotherapy in Non-High-Risk Acute Promyelocytic Leukemia: Final Results of the Randomized Italian-German APL0406 Trial https://air.unimi.it/handle/2434/429739

Effective Treatment of Acute Promyelocytic Leukemia With All-Trans-Retinoic Acid, Arsenic Trioxide, and Gemtuzumab Ozogamicin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881307/

All-Trans-Retinoic Acid, Idarubicin, and IV Arsenic Trioxide as Initial Therapy in Acute Promyelocytic Leukemia (APML4) https://ashpublications.org/blood/article/120/8/1570/30826/All-trans-retinoic-acid-idarubicin-and-IV-arsenic

Resistance to Arsenic Trioxide and Retinoic Acid Therapy in Acute Promyelocytic Leukemia https://link.springer.com/article/10.1007/s00277-017-2923-z

Relationship Between FLT3 Mutation Status, Biologic Characteristics, and Response to Targeted Therapy in Acute Promyelocytic Leukemia https://ashpublications.org/blood/article/106/12/3768/109752/Relationship-between-FLT3-mutation-status-biologic