From the H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL (Dr. Shah), and the Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL (Dr. Lancet)
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Jeffrey E. Lancet, MD, Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr, Tampa, FL; e-mail: jeffrey.lancet{at}moffitt.org
Overview: Acute myeloid leukemia (AML) has been treated traditionally using a combination of cytarabine and daunorubicin. A better understanding of the role of age and molecular changes has allowed for better prediction of patients who are likely to attain or maintain a complete remission using conventional therapy and for targeting experimental approaches toward patients who are not. Such treatment approaches have included dose/schedule modifications of these agents and incorporation of novel agents into the treatment regimen. These disparate approaches to the care of AML have uncovered potential roles for alternative agents, including modulators of multidrug resistance, purine analogs, alkylating compounds, and targeted agents. Although inclusion of many of these agents into frontline treatment of AML has produced improvements in the complete remission rate, reproducible benefits in overall survival have yet to be demonstrated, typically as a consequence of high relapse rates. In the future, it is expected that more accurate identification of patient-specific biologic and clinical disease variables will be necessary for the optimal use of novel agents, both alone and in combination.
