Tailoring Treatment for Secondary AML in Older Patients

Eunice S. Wang, MD, chief of the Leukemia Service at Roswell Park Comprehensive Cancer Center, discusses a retrospective study of 105 patients diagnosed with secondary acute myeloid leukemia (AML).

The study focused on mainly patients in their 70s and 80s and analyzed the outcomes of those treated with either lower-dose venetoclax [Venclexta]-based therapy or intensive chemotherapy.

The results revealed that lower-dose chemotherapy was not beneficial for older patients, with a median overall survival of only 5 months. In contrast, those who received intensive chemotherapy followed by transplantation had significantly better outcomes, with a median survival closer to 10 months. Patients who underwent transplantation survived for over a year, while those on lower-intensity therapy often had survival times as short as 3 to 5 months.

Transcription:

0:10 | We conducted a retrospective study of patients at Roswell Park who had been diagnosed with secondary AML. We looked at their prior therapies and outcomes. [Among the 105 patients identified]—predominantly in their 70s and 80s, with ages ranging all of the way up to 91—we analyzed the impact of their treatments. Patients received either lower-dose venetoclax-based therapy or intensive chemotherapy, [such as a standard intensive approach.

0:55 | Our findings showed that lower-dose chemotherapy was not necessarily beneficial for this older age population. Patients treated with intensive chemotherapy, ideally followed by transplantation, had significantly better outcomes. The median overall survival across all 105 patients was 7.7 months. However, those who received intensive therapy had a median survival of closer to 10 months, compared with 5 months for those receiving lower-intensity therapy. Furthermore, patients who underwent transplantation lived longer than a year. Patients treated with lower-intensity therapy often had survival as short as 3 to 5 months.

1:46 | These results emphasize that lower-intensity therapy is not universally appropriate for all older patients with AML. Prior therapies and disease history must be carefully considered when treating these individuals. Typically, older patients without a history of MDS or prior treatment might have a median survival of approximately 14 months, which we did not observe in this subgroup. This underscores the importance of tailoring treatment strategies for secondary AML in older adults. This was the key finding of our abstract.