Clinical Hematology International

Volume 1, Issue 2, June 2019, Pages 94 - 100

Salvage Therapy after Allogeneic Hematopoietic Cell Transplantation: Targeted and Low-Intensity Treatment Options in Myelodysplastic Syndrome and Acute Myeloid Leukemia

Authors
Katie Culos1, Michael Byrne2, *
1Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN, USA
2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
*Corresponding author. Email: michael.byrne@vumc.org
Corresponding Author
Michael Byrne
Received 18 March 2019, Accepted 17 April 2019, Available Online 10 May 2019.
DOI
10.2991/chi.d.190503.001How to use a DOI?
Keywords
Myelodysplastic syndrome; Acute myeloid leukemia; Hematopoietic cell transplantation; Relapse
Abstract

Patients with high-risk myeloid neoplasms, including myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), are offered allogeneic hematopoietic cell transplantation (alloHCT) to improve the likelihood of long-term disease control. More than 50% of patients with high-risk disease will relapse after HCT and face a poor prognosis with shortened survival. The recent development of targeted therapies and effective, low-intensity treatment strategies will likely improve the outcomes of these patients. In MDS, hypomethylating agents (HMAs) are the mainstay of salvage therapy but new treatments with APR-246 and luspatercept demonstrate excellent results in phase 1 and phase 3 clinical studies, respectively. In AML, new directed agents in the relapsed/refractory setting include gilteritinib (FLT3-ITD/-TKD), ivosidenib (IDH1), and enasidenib (IDH2). In patients without targetable mutations, HMAs may be used, and early data with venetoclax-based regimens are encouraging.

Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal
Clinical Hematology International
Volume-Issue
1 - 2
Pages
94 - 100
Publication Date
2019/05/10
ISSN (Online)
2590-0048
DOI
10.2991/chi.d.190503.001How to use a DOI?
Copyright
© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
Open Access
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

TY  - JOUR
AU  - Katie Culos
AU  - Michael Byrne
PY  - 2019
DA  - 2019/05/10
TI  - Salvage Therapy after Allogeneic Hematopoietic Cell Transplantation: Targeted and Low-Intensity Treatment Options in Myelodysplastic Syndrome and Acute Myeloid Leukemia
JO  - Clinical Hematology International
SP  - 94
EP  - 100
VL  - 1
IS  - 2
SN  - 2590-0048
UR  - https://doi.org/10.2991/chi.d.190503.001
DO  - 10.2991/chi.d.190503.001
ID  - Culos2019
ER  -