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Publications

Journal Article Review Epublish 1 citation

PubMed: 42505233 DOI: 10.3390/curroncol33070431

Controversies in the Management of AML in Older Patients: A Canadian Perspective.

Curr Oncol 33(7)

Authors: Andre C Schuh, Joseph Brandwein, Mahmoud Elsawy, David Sanford, Brian Leber

Affiliations

  • Departments of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2M9, Canada.
  • Department of Medicine, University of Toronto, Toronto ON M5S 1A8, Canada.
  • Division of Hematology, Department of Medicine, University of Alberta, Edmonton, AB T6G 2G3, Canada.
  • Division of Hematology and Hematologic Oncology, Department of Medicine, Dalhousie University, Halifax, NS B3H 2Y9, Canada.
  • QEII Health Sciences Centre, Halifax, NS B3H 3A7, Canada.
  • Division of Hematology, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
  • Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada.

Abstract

In the companion article in this issue of Current Oncology, 'Management of AML in Older Patients: An Updated Canadian Consensus', the authors have presented the third iteration of Canadian consensus guidelines on AML treatment in the elderly. While many aspects of AML treatment in the elderly have become better defined, some old questions remain and new questions and controversies have arisen. Here, we address three topics on which there is, at this time, no universal consensus. The first is the development and features of new risk-stratification systems specifically aimed at older, less-intensively treated patients. Several different systems now exist in parallel, potentially causing confusion amongst clinicians. The second topic is good-prognosis AML subtypes (IDH1- and NPM1-mutated AML). In the Canadian context, IDH1-mutated AML is of particular interest due to the new availability of ivosidenib in Canada. The third topic is adverse-risk AML subtypes (FLT3- and TP53-mutated AML). FLT3-mutated AML remains problematic, although it is anticipated that new drug approvals and measurable residual disease-based treatment approaches may alleviate this, at least in part. And in particular, TP53-mutated AML remains a major problem. Ongoing clinical trial enrollment is essential.

MeSH

Neoplasms, Leukemia, Myeloid, Acute, Aged, Therapeutics