Salvage Therapy after Allogeneic Hematopoietic Cell Transplantation: Targeted and Low-Intensity Treatment Options in Myelodysplastic Syndrome and Acute Myeloid Leukemia
- 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/).
Download article (PDF)
View full text (HTML)
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 -