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Acute Leukemia Forum 2000, Advances and Controversies in the Therapy of Acute Myelogenous Leukemia

New agents for induction and postremission therapy of acute myeloid leukemia

Leukemia volume 15, pages 675–676 (2001)Cite this article

Recent studies of the molecular basis of myeloid transformation have led to the identification of novel intracellular targets for leukemia therapy. The first group of agents developed to target a specific enzymatic pathway in acute myeloid leukemia (AML) was the ribonucleotide reductase inhibitors, including fludarabine, cladrabine, clofarabin, and, most recently, gemcitabine. Other intracellular targets for which small molecule inhibitors or biomodulators have been identified include histone deacetylase, protein kinase C, farnesyl transferase, and cyclin-D. Antibodies targeting cell surface receptors on myeloid cells, such as CD33, have been engineered and have demonstrated efficacy alone and, more recently, in immunoconjugates. In addition to the identification of novel agents, rational strategies to combine targeted therapies with conventional cytotoxic agents are being explored.

Anthracyclines have traditionally been a mainstay of AML therapy. Idarubicin is the most recent anthracycline to be developed. The availability of oral idarubicin has led to the development of outpatient anthracycline-based therapies for elderly or refractory patients. A study of weekly oral idarubicin at a dose of 20 mg/m2 administered weekly for 4 weeks with a second induction at 40 mg/m2 × 4 weeks in a group of elderly AML patients demonstrated a complete response rate of 25% with 4% partial responses.1 The disease-free survival was 9.6 months. One-third of the patients did not require hospitalization, and the median number of hospital days for those requiring hospitalization was 14.5. Oral idarubicin was both safe and effective in this group of elderly AML patients.

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  1. University of Chicago, Chicago, IL, USA

    RA Larson

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Larson, R. New agents for induction and postremission therapy of acute myeloid leukemia. Leukemia 15, 675–676 (2001). https://doi.org/10.1038/sj.leu.2402064

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