[Maintenance therapy for acute myeloid leukemia (including in patients who have undergone transplantation) including off-label use drugs in Japan]

Rinsho Ketsueki. 2021;62(8):978-987. doi: 10.11406/rinketsu.62.978.
[Article in Japanese]

Abstract

Recurrence in acute myeloid leukemia (AML) is a major barrier in patients who achieve complete remission after induction of remission and consolidation therapy and desire long-term survival. Allogeneic hematopoietic stem cell transplantation lowers recurrence risk in patients; however, recurrence is common even after transplantation. Many maintenance therapies for AML aim to lower recurrence risk; therefore, research has focused on identifying drugs with a tolerable adverse-effect profile. Thus far, many trials of cytotoxic anticancer drugs used in maintenance therapy have showed no improvement in survival rates. In contrast, recent studies on immunomodulation, epigenetics, molecular-targeted drugs, etc. have demonstrated promising results. Therefore, we plan to review various maintenance therapies, such as immunotherapy, demethylating agents, and targeted therapies (including fms-like tyrosine kinase 3 inhibitors in particular) based on the current evidence. Moreover, we describe a new strategy that incorporates the assessment of measurable minimal residual disease.

Keywords: Acute myeloid leukemia; Hypomethylating agents; Maintenance therapy; Targeted therapies.

Publication types

  • Review

MeSH terms

  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Japan
  • Leukemia, Myeloid, Acute* / drug therapy
  • Off-Label Use
  • Pharmaceutical Preparations*
  • Remission Induction

Substances

  • Pharmaceutical Preparations