New Drugs in the Treatment of Acute Myeloid Leukemia in the Elderly
Authors:
Z. Šustková; M. Čulen; L. Semerád; I. Ježíšková; D. Dvořáková; Z. Ráčil; J. Mayer
Authors‘ workplace:
Interní hematologická a onkologická klinika LF MU a FN Brno
Published in:
Klin Onkol 2017; 30(3): 190-196
Category:
Review
doi:
https://doi.org/10.14735/amko2017190
Overview
Background:
At the time of diagnosis, most patients with acute myeloid leukemia are older than 65 years of age. Treatment of this group of patients is challenging because they become less tolerant to aggressive chemotherapy with increasing age. Less than one-third of elderly patients are considered eligible for intensive treatment; nevertheless, the survival analysis for this population remains poor. Due to numerous comorbidities and an overall deteriorating condition, most elderly patients with acute myeloid leukemia receive only palliative or best supportive care, which are associated with a high mortality rate. New therapeutic approaches are expected to improve the overall survival and quality of life of this group of patients. These promising treatments include cell kinase inhibitors, cytotoxic agents, monoclonal antibodies, and epigenetic therapy including hypomethylating agents and inhibitors of isocitrate dehydrogenase and histone deacetylase. In monotherapy, these new drugs show lower levels of toxicity than those commonly used in chemotherapy; however, they do not lead to a better long-lasting treatment response. To enhance therapeutic efficacy, combinations of the above-mentioned treatments are often used, and, during clinical trials, combinations with standard cytostatics are also common. The promising results of these studies show that even low-toxicity therapies can lead to a better overall treatment response and to longer overall survival.
Aim:
This article provides a brief overview of new drugs that are evaluated for their mechanism of effect, efficacy and toxicity in therapy of patients suffering from acute myeloid leukemia.
Key words:
acute myeloid leukemia – elderly – FLT3 inhibitors – epigenetic therapy – monoclonal antibodies
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted:
4. 11. 2016
Accepted:
13. 12. 2016
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