Dr. Perl on Choosing the Optimal Therapy in AML

Alexander E. Perl, MD, MS, associate professor of medicine, University of Pennsylvania, Perelman School of Medicine, discusses how to assess what therapy is best for patients with acute myeloid leukemia (AML).

In the past, AML treatment was largely a one-size-fits-all approach. Patient fitness was the only criteria that was used to determine whether to administer induction 7+3 chemotherapy, low-intensity treatment with low-dose cytarabine or hypomethylating agent, or supportive care for patients who could not tolerate either therapy.

Today, the genetic composition of the leukemia is used to determine the optimal therapy. Fitness still plays a role in determining whether a patient should receive intensive or low-intensity treatment. Notably, induction strategies that are personalized to the genetic makeup of the disease result in improved survival, says Perl.

Personalized approaches confer improved survival across subtypes of AML, adds Perl, including therapy-related AML, myelodysplastic syndrome-related AML, FLT3-mutant AML, and core-binding factor AML.