New Insights Into Secondary AML Treatment

Eunice S. Wang, MD, chief of the Leukemia Service at Roswell Park Comprehensive Cancer Center, discusses research behind optimal therapy for acute myeloid leukemia (AML) secondary to other malignancies, particularly in patients with prior myelodysplastic syndrome (MDS). These patients had previously been treated for MDS with hypomethylating agents such as azacitidine or decitabine.

This research, which was presented at the 2024 ASH Annual Meeting and Exposition, emphasizes the importance of tailoring treatment for older patients with secondary AML, taking into account their unique disease history and prior therapies to improve outcomes.

Transcription:

0:10 | Our abstract focused on optimal therapy for acute myeloid leukemia secondary to other malignancies or states. Specifically, we were looking at patients who had secondary AML following a prior diagnosis of myelodysplastic syndrome, who had been treated previously for their myelodysplastic syndrome with hypomethylating agents.

0:32 | As the general population ages, the age of presentation of acute myeloid leukemia has also risen. The majority of patients diagnosed with AML are now often in their 70s or 80s. Many of these patients have a history of a pre-leukemic state, such as myelodysplastic syndrome. Standard therapy for myelodysplastic syndrome involves agents like azacitidine and decitabine. However, when these older, less fit individuals progress to acute myeloid leukemia, they are often offered treatment with the same drugs, combined with a BCL-2 inhibitor like venetoclax [Venclexta].

1:20 | [Patients with secondary AML] were excluded from the initial clinical trials evaluating the benefit of venetoclax with, for example, azacitidine for acute myeloid leukemia treatment. [Our study] aimed to assess whether these patients, having already been treated with hypomethylating agents for MDS, benefit from the standard azacitidine-based therapy for AML or require a different treatment approach.