J Korean Med Assoc.  2023 Apr;66(4):234-244. 10.5124/jkma.2023.66.4.234.

Changing the strategic paradigm for the treatment of adult acute myeloid leukemia

• Cheong JW
• Min YH

• KMID: 2541904
• DOI: http://doi.org/10.5124/jkma.2023.66.4.234

Abstract

Background
Acute myeloid leukemia (AML) is a representative blood cancer, accounting for most adult leukemia cases in Korea. Until recently, intensive chemotherapy and hematopoietic stem cell transplantation were the only curative treatment options for AML. However, the recent introduction of new drugs is bringing about changes in the strategic paradigm for the treatment of AML.
Current Concepts
Along with the clinical eligibility for receiving intensive treatment and hematopoietic stem cell transplantation, the most critical determinants in treating AML are precise classification and risk stratification based on cytogenetic and molecular information. The recently revised World Health Organization classification, newly proposed International Consensus Classification, and the latest version of the European LeukemiaNet risk stratification reflect the importance of cytogenetic and molecular information. Although there have been no significant changes for a long time in the landscape of AML, especially in the field of treatment, the treatment paradigm has started to evolve with the introduction of new drugs. This evolution is led by FLT3 inhibitors, Bcl-2 inhibitors, isocitrate dehydrogenase inhibitors, target agents against CD33 antigens, and liposomal formulations of chemotherapeutics.
Discussion and Conclusion
Successful initial treatment to induce complete remission followed by post-remission treatment to remove residual disease can lead to the achievement of long-term survival and cure goals in AML. We hope that new drugs will markedly improve the treatment outcomes for patients with AML.

Keyword

Acute myeloid leukemia; Therapeutics; Drug therapy; 급성골수성백혈병; 치료; 약물요법