Acute Myeloid Leukemia (AML) Relapse Options
- If AML returns after a year, patients will follow general protocols where initial treatment is repeated and a stem cell transplant may be offered
- Targeted therapies are recommended to patients whose remission lasts less than a year
- IDH1 and IDH2 Inhibitors are FDA approved medication with successful response rates for reoccurring AML
Dr. Tibes explains that treatment options after relapse are often determined by when the disease recurs after initial remission. Patients who were in remission for a year or more and experience a reoccurrence are often put back on initial treatment and undergo a stem cell transplant, if possible. For patients whose remission lasts less than a year, physicians will look for targeted therapies in order to determine molecular and genetic factors in the leukemia cells.
Read MoreIDH1 and IDH2 Inhibitors
Dr. Tibes is excited about IDH1 and IDH2 Inhibitors, which are medications receiving approval by the Food and Drug Administration (FDA) because of successful response rates for relapsed AML. However, Dr. Tibes says that the overall amount of medication for AML treatment is still too small. “The challenge is that we in a way know more about the genes and the molecular makeup of leukemia cells than we have medication and drugs available,” according to Dr. Tibes. “So despite the approval of several medications from the FDA for AML over the past couple of years, we still have a long way to go.”Stem Cell Transplants During Relapses In Acute Myeloid Leukemia (AML)
AML will usually go into remission after initial treatment. However, if AML returns then physicians will consider a stem cell transplant (SCT), also known as a bone marrow transplant, which allows an extremely high dose of cancer-killing chemotherapy to be given. Following the transplant, patients are given stem cell infusions to restore bone marrow. However, physicians must decide if a person is eligible for the procedure.
"What does eligible mean? It means you're pretty healthy, your heart works okay, your lungs work okay… Doctors like to make sure a person can walk, can do the normal days activities, before saying a patient is healthy enough to go for a transplant,” Dr. Nina Shah, who treats blood cancer at The University of California, San Francisco (UCSF).
The most common form of stem cell transplant to treat AML is an allogeneic stem cell transplant, where the stem cells come from a donor whose tissue type matches the patient’s. Transplant cells can come from donors who are family members, unrelated donors, or from chord blood.
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