Hello, I’m Dr. Jonathan Abbas. I’m the director of the acute leukemia and blood cancer program with Tennessee Oncology in Nashville, Tennessee. I specialize in hematologic malignancies, specifically acute leukemia, and my center treats over a hundred patients a year with aggressive chemotherapy for AML many of whom have sAML, including t-AML and AML-MRC.
Due to poor prognosis in sAML patients, the goal should be to get appropriate patients to HSCT because:
- Patients with AML-MRC and t-AML who undergo HSCT after chemotherapy have been shown to have better outcomes compared with chemotherapy alone
- The outcomes of older AML patients undergoing hematopoietic stem cell transplant has improved
- An increasing amount of older patients may be eligible for stem cell transplant
One of the major breakthroughs in hematopoietic stem cell transplant in the last 20 years is the use of reduced intensity conditioning to be able to transplant patients in their 60s and 70s. As this is the age range in which most sAML patients present, this means that now these patients have a potential pathway to a cure. Of course, we cannot perform a stem cell transplant on a AML patient unless they have achieved a complete remission. By using VYXEOS, we now open the door to a potential curative transplant for patients with sAML in their 60s and 70s.
Factors to consider for hematopoietic stem cell transplant eligibility include: comorbidities, older age, disease biology as in refractory or a short period of remission, physical impairment or poor performance status.
In the Phase 3 trial, 35% of VYXEOS-treated patients received a hematopoietic stem cell transplant after treatment compared to 25% of patients treated with 7+3.
Furthermore, a greater proportion of patients who achieved first CR with VYXEOS (20%) vs 7+3 (12%) subsequently underwent hematopoietic stem cell transplant.
Managing patients with secondary AML can be challenging, but I hope what I discussed today can offer clinicians in the community setting additional treatment options that can help improve outcomes for their secondary AML patients. Thank you.
VYXEOS is indicated for the treatment of newly-diagnosed therapy-related acute myeloid leukemia (t‑AML) or AML with myelodysplasia-related changes (AML-MRC) in adults and pediatric patients 1 year and older.
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