The long-term survival rate of recurrent AML in children is still low, but the new therapy brings hope

the-scientist

the-scientist

According to data from the National Cancer Institute, in the past few decades, treatment results for childhood , adolescent and young adult leukemia have improved significantly, with a 5-year relative survival rate of 85.

The results of the treatment of leukemia in children , adolescents and young adults have been significantly improved, with a 5-year relative survival rate of 85.

stem cell

Patrick A.

There are clear and compelling reasons to develop therapies that specifically target the molecular abnormalities that cause leukemia

consensus

Pediatric relapsed acute myeloid leukemia: a systematic.

The results of the study showed that the most frequently reported statistically significant prognostic factor was the duration of CR1

The review showed that the results of CR2 varied, with an average 2-year and 10-year overall survival rate of 64% and 31%, respectively

The results of CR2 vary, with average 2-year and 10-year overall survival rates of 64% and 31%, respectively

Results related to CR2 treatment type

New drug therapies that can be combined with conventional chemotherapy provide opportunities to improve clinical outcomes

An earlier report emphasized that strict adult follow-up is essential for all survivors of pediatric relapsed AML, because new treatments may be accompanied by side effects and delayed effects

The Director of the Pediatric Leukemia Program at the Sidney Kimmel Comprehensive Cancer Center, Brown commented: The current study results are consistent with his 15 years of experience in treating children with relapsed AML.

For these trials, it is also important to combine new molecular targeting and immunotherapeutic approaches to take advantage of the rapidly expanding understanding of AML biology

Molecular targeted immunity

Recently, a phase I dose escalation study of Venetoque combined with conventional intensive chemotherapy for patients with relapsed or refractory AML from 3 to 22 years of age has provided new hope, at least for some patients.

Venetoclax in combination with cytarabine with or without idarubicin in children with relapsed or refractory acute myeloid leukaemia: a phase 1, dose-escalation study.

Venetoclax in combination with cytarabine with or without idarubicin in children with relapsed or refractory acute myeloid leukaemia: a phase 1, dose-escalation study.

This is the first study of Venetog therapy in children and young people with recurrent acute myeloid leukemia

diagnosis

Researchers found that the recommended phase II dose of venetoclax is 360 mg/m  ² (maximum 600 mg) combined with cytarabine (1000 mg/m  ² per dose , eight doses in total), with or without idarubicin (12 mg/m  ² as a single dose)
.
Of the 20 evaluable patients treated at the recommended Phase II dose, 14 (70%) showed complete remission after one treatment cycle, with or without complete hematological recovery
.
It is worth noting that 10 patients (71%) had negative minimal residual disease
.

 ^{2  2  2} 20 evaluable patients at the recommended Phase II dose therapy, 14 (70%) after one cycle of treatment showed complete remission with or without complete hematologic recovery
.
It is worth noting that 10 patients (71%) had negative minimal residual disease
.
Of the 20 evaluable patients treated at the recommended Phase II dose, 14 (70%) showed complete remission after one treatment cycle, with or without complete hematological recovery
.
It is worth noting that 10 patients (71%) had negative minimal residual disease
.

Dose escalation and response after one cycle

Dose escalation and response after one cycle

A total of 22 patients (66%) developed grade 3-4 febrile neutropenia, and 6 patients (16%) each developed bloodstream and invasive fungal infections
.
One person died due to treatment-related colitis and sepsis
.

Infect

The author pointed out that although the previous treatment burden of this pediatric study population was heavier, after two cycles of intensive treatment with fludarabine (Fludara), cytarabine and granulocyte colony stimulating factor, the overall response rate was less than The response rates in the AML 2001/01 study report are similar
.

These results are also more favorable than the results of AAML1421 after one cycle of treatment with CPX-351 (Vyxeos)
.
Rubnitz and colleagues say that these data suggest that complete responses may be more frequent when venetoclax is used in combination with high-dose chemotherapy rather than medium-dose cytarabine
.

These data suggest that complete responses may be more frequent when venetoclax is used in combination with high-dose chemotherapy rather than medium-dose cytarabine
.
These data suggest that complete responses may be more frequent when venetoclax is used in combination with high-dose chemotherapy rather than medium-dose cytarabine
.

The study also showed that all five patients with FLT3 activation did not respond
.
For these patients, combining venetoclax with FLT3 inhibitors is an attractive treatment
.
In addition, patients with only BCL-XL dependent samples responded poorly to treatment, and one patient changed from BCL-2 dependence to BCL-XL dependence after one treatment cycle
.

references:

references:

1.
Pediatric relapsed acute myeloid leukemia: a systematic.
DOI:10.
1080/14737140.
2021.
1841640

1.
Pediatric relapsed acute myeloid leukemia: a systematic.
DOI:10.
1080/14737140.
2021.
1841640

2.
Venetoclax in combination with cytarabine with or without idarubicin in children with relapsed or refractory acute myeloid leukaemia: a phase 1, dose-escalation study.
DOI:https://doi.
org/10.
1016/S1470-2045(20)30060- 7

2.
Venetoclax in combination with cytarabine with or without idarubicin in children with relapsed or refractory acute myeloid leukaemia: a phase 1, dose-escalation study.
DOI:https://doi.
org/10.
1016/S1470-2045(20)30060- 7

leave a message here