Acute myeloid leukemia: Treatment and research outlook for 2021 and the MD Anderson approach

The unraveling of the pathophysiology acute myeloid leukemia (AML) has resulted in rapid translation information into clinical practice. After more than 40 years slow progress AML research, US Food and Drug Administration approved nine agents for different treatment indications since 2017. In this review, we detail that been made research AML, citing key publications related to therapy English literature 2000. notable subsets include promyelocytic (APL), core-binding factor (CBF-AML), younger patients fit intensive chemotherapy, older/unfit (usually at age cutoff 60-70 years). We also consider within each subset whether is primary or secondary (therapy-related, evolving from untreated treated myelodysplastic syndrome myeloproliferative neoplasm). APL, with all-trans retinoic acid arsenic trioxide results estimated 10-year survival rates ?80%. Treatment CBF-AML fludarabine, high-dose cytarabine, gemtuzumab ozogamicin (GO) ?75%. younger/fit patients, “3+7” regimen (3 days daunorubicin + 7 cytarabine) produces less favorable (estimated 5-year 35%; worse real-world experience); regimens incorporate adenosine nucleoside analogs, GO are producing better results. Adding venetoclax, FLT3, IDH inhibitors these encouraging preliminary data. low-intensity hypomethylating (HMAs) venetoclax now new standard care. Better incorporating cladribine, low-dose other targeted therapies (FLT3 inhibitors) emerging. Maintenance a definite role oral HMAs potential benefits available. conclusion, rapidly improving all as novel strategies incorporated traditional chemotherapy. LAY SUMMARY Ongoing progressing rapidly. Since 2017, 10 drugs indications. This review updates pathways AML.