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Acute Myeloid Leukemia: From Diagnosis to Treatment

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (30 November 2024) | Viewed by 3303

Special Issue Editor


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Guest Editor
West Virginia University Cancer Institute, Wheeling Hospital, Wheeling, WV, USA
Interests: AML; acute myeloid leukemia; hematology

Special Issue Information

Dear Colleagues,

Acute myeloid leukemia (AML) is an aggressive hematologic malignancy and the most common acute leukemia in adults.  For many years, the standard treatment for AML consisted of intensive and prolonged chemotherapy with a combination of cytarabine and an anthracycline, commonly referred to as “7+3”. In addition to the toxicities and lengthy, frequent hospitalizations associated with this regimen, most patients, including those with "favorable" risk factors experienced frequent relapses and short survival times. Over the past two decades, the genetic and molecular underpinnings of AML have become better defined, thereby paving the way for refinements in the disease classification, risk-stratification, and development of newer and better tolerated treatment options. As such, the diagnosis and treatment paradigm for AML has become more personalized, but also more complex.  In this Special Issue, we focus on the most recent updates regarding AML diagnosis and classification, as well as on newest therapies for AML that are currently available and those under development. We will discuss factors that are considered when tailoring a treatment decision, both in newly diagnosed and relapsed/refractory settings, including the role of allogeneic stem cell transplant and the current state of cellular therapies.

In this Special Issue, original research articles and reviews within the scope of the topics described above are welcome.

I look forward to receiving your contributions.

Dr. Bhavana Bhatnagar
Guest Editor

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Keywords

  • acute myeloid leukemia
  • treatment
  • risk factors
  • classification
  • diagnosis

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Published Papers (2 papers)

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Research

18 pages, 1467 KiB  
Article
Impact of Venetoclax Treatment Schedule on Hematologic Recovery and Treatment Response in AML Patients Unfit for Intensive Chemotherapy
by Anja Schüpbach, Dilara Akhoundova, Ulrike Bacher, Henning Nilius, Michèle Hoffmann, Carlo R. Largiadèr, Yolanda Aebi, Michael Hayoz, Marie-Noëlle Kronig and Thomas Pabst
Cancers 2025, 17(7), 1138; https://doi.org/10.3390/cancers17071138 - 28 Mar 2025
Viewed by 558
Abstract
(1) Background: The combination of venetoclax and hypomethylating agents (HMAs) is a standard first-line regimen for acute myeloid leukemia (AML) patients unfit for intensive chemotherapy. Since venetoclax-HMAs are usually administered until progression and delayed hematologic recovery is one of the limiting toxicities, cyclic [...] Read more.
(1) Background: The combination of venetoclax and hypomethylating agents (HMAs) is a standard first-line regimen for acute myeloid leukemia (AML) patients unfit for intensive chemotherapy. Since venetoclax-HMAs are usually administered until progression and delayed hematologic recovery is one of the limiting toxicities, cyclic administration including 7–14-day breaks is recommended. However, whether longer venetoclax schedules lead to higher response rates and how venetoclax pharmacokinetics correlate with toxicity and efficacy remains unclarified. In this single-center retrospective study, we analyzed how venetoclax plasma levels and treatment duration impact hematologic toxicity and treatment responses. (2) Methods: We analyzed the safety and efficacy of venetoclax-HMA combination regimens in a cohort of AML patients unfit for intensive chemotherapy treated at our institution between June 2020 and September 2023. The primary endpoint was the correlation between venetoclax plasma levels or administration schedule with hematologic recovery after the first cycle. Secondary endpoints included the following clinical outcomes: correlation with complete response (CR) status, progression-free survival, and overall survival. (3) Results: Within our cohort of 75 AML patients, we found no correlation between venetoclax plasma peak and trough levels, or venetoclax treatment duration (≤ or >14 days), and hematologic toxicity. Patients receiving shorter venetoclax schedules (≤14 days) had similar CR rates compared to patients treated with longer schedules. (4) Conclusions: Our results suggest that shorter (≤14 days) venetoclax schedules may have no negative impact on tumor responses in AML patients receiving venetoclax and HMA combinations. However, prospective validation studies would be required to confirm these findings. Full article
(This article belongs to the Special Issue Acute Myeloid Leukemia: From Diagnosis to Treatment)
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14 pages, 1218 KiB  
Article
Treatment Outcomes of Adolescents Compared to Younger Pediatric Patients with Acute Myeloid Leukemia: Do They Need a Special Approach?
by Katarzyna Pawińska-Wąsikowska, Małgorzata Czogała, Karolina Bukowska-Strakova, Marta Surman, Monika Rygielska, Teofila Książek, Beata Sadowska, Agnieszka Pac, Jolanta Skalska-Sadowska, Magdalena Samborska, Jacek Wachowiak, Małgorzata Ciebiera, Radosław Chaber, Renata Tomaszewska, Tomasz Szczepański, Karolina Zielezińska, Tomasz Urasiński, Małgorzata Moj-Hackemer, Krzysztof Kałwak, Marta Kozłowska, Ninela Irga-Jaworska, Barbara Sikorska-Fic, Paweł Łaguna, Katarzyna Muszyńska-Rosłan, Maryna Krawczuk-Rybak, Anna Fałkowska, Katarzyna Drabko, Katarzyna Bobeff, Wojciech Młynarski, Agnieszka Chodała-Grzywacz, Grażyna Karolczyk, Katarzyna Mycko, Wanda Badowska, Natalia Bartoszewicz, Jan Styczyński, Katarzyna Machnik, Agnieszka Mizia-Malarz, Walentyna Balwierz and Szymon Skoczeńadd Show full author list remove Hide full author list
Cancers 2024, 16(6), 1145; https://doi.org/10.3390/cancers16061145 - 14 Mar 2024
Cited by 1 | Viewed by 2092
Abstract
Background: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. Patients and Methods: We retrospectively analyzed 220 AML patients aged 0–18 years treated in pediatric oncologic centers in Poland [...] Read more.
Background: The reports of studies that compare the survival of adolescents and young adults with younger children with acute myeloid leukemia (AML) are contradictory. Patients and Methods: We retrospectively analyzed 220 AML patients aged 0–18 years treated in pediatric oncologic centers in Poland from 2015 to 2022. The evaluated group included 31 infants (below 1 year), 91 younger children (1–9.9 years), 59 older children (10–14.9 years), and 39 adolescents (15–18 years). Results: A 5-year overall survival for adolescents was not significantly inferior compared to younger and older children (74.3 ± 7.6% vs. 80.5 ± 4.4% vs. 77.9 ± 5.1, p = 0.243). However, relapse-free survival was lower in adolescents compared to younger children (76.5 ± 7.8% vs. 65.7 ± 9.0%, p = 0.049), and treatment-related mortality tended to be higher (10.3% vs. 4.4%, p = 0.569). In the univariate analysis, high-risk genetics [HR, 2.0 (95% CI 1.1–3.6; p = 0.014)] and a leukocyte count at diagnosis above 100,000/μL [HR, 2.4 (95% CI 1.3–4.6; p = 0.004)] were found to be unfavorable prognostic factors for survival. Conclusions: Although we have not found that age over 15 years is an unfavorable factor for overall survival, the optimal approach to therapy in adolescents, as in other age groups, is to adjust the intensity of therapy to individual genetic risk and introduce targeted therapies when indicated. Full article
(This article belongs to the Special Issue Acute Myeloid Leukemia: From Diagnosis to Treatment)
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