Patient experiences of acute myeloid leukemia: A qualitative study about diagnosis, illness understanding, and treatment decision-making

2016 ◽  
Vol 26 (12) ◽  
pp. 2063-2068 ◽  
Author(s):  
Thomas W. LeBlanc ◽  
Laura J. Fish ◽  
Catherine T. Bloom ◽  
Areej El-Jawahri ◽  
Debra M. Davis ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Myeloid Leukemia ◽  
Qualitative Study ◽  
Myeloid Leukemia ◽  
Treatment Decision ◽  
Patient Experiences ◽  
Treatment Decision Making ◽  
Acute Myeloid

Effect of Age on Treatment Decision-Making in Elderly Patients With Acute Myeloid Leukemia

2015 ◽  
Vol 15 (8) ◽  
pp. 477-483 ◽  
Author(s):  
Jihane Fattoum ◽  
Giovanna Cannas ◽  
Mohamed Elhamri ◽  
Isabelle Tigaud ◽  
Adriana Plesa ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Myeloid Leukemia ◽  
Elderly Patients ◽  
Myeloid Leukemia ◽  
Treatment Decision ◽  
Treatment Decision Making ◽  
Effect Of Age ◽  
Acute Myeloid

More Versus Less Therapy for Older Adults With Acute Myeloid Leukemia: New Perspectives on an Old Debate

2019 ◽  
pp. 421-432 ◽  
Author(s):  
Heidi D. Klepin ◽  
Elihu Estey ◽  
Tapan Kadia
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Decision ◽  
Important Conclusion ◽  
Treatment Decision Making ◽  
Acute Myeloid

Most patients with newly diagnosed acute myeloid leukemia (AML) are at least age 65 and continue to have short survival, with many patients receiving no specific anti-AML therapy, particularly if they are older than age 75. Although consensus regarding optimal treatment of this growing population is lacking, treatment options are expanding even for the oldest patients. A fundamental question when seeing an older patient with AML is whether to recommend “more intensive” or “less intensive” induction therapy. Existing data can support more intensive treatment strategies for selected older adults, although there is growing evidence to support less intensive therapies as well. Randomized trials to provide clear comparisons between treatment strategies among well-characterized older adult populations are lacking. Reliance on age alone to determine treatment choice is problematic, as “fitness” or “unfitness” varies dramatically among patients of the same chronologic age and remains poorly characterized in existing studies. This article will provide differing perspectives on the “more” versus “less” question, with particular attention to recent drug approvals. Issues relevant to both treatment decision-making in practice and alternative trial design to inform gaps in knowledge will be discussed. Given the heterogeneity, an important conclusion will be that there is unlikely to be a single best approach and that appropriate decision-making requires considerations of many factors specific to individual patients.

How Precision Medicine Is Changing Acute Myeloid Leukemia Therapy

2019 ◽  
pp. 411-420 ◽  
Author(s):  
Michael Heuser ◽  
Alain Mina ◽  
Eytan M. Stein ◽  
Jessica K. Altman
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Residual Disease ◽  
Treatment Decision ◽  
Response Assessment ◽  
Response To Treatment ◽  
Multiparameter Flow Cytometry ◽  
Treatment Decision Making ◽  
Prognostic Assessment ◽  
Acute Myeloid

Pretreatment somatic mutations influence acute myeloid leukemia (AML) pathogenesis and responses to chemotherapy. Integration of cytogenetic abnormalities and molecular mutations, co-occurring and in isolation, have resulted in a more refined prognostic assessment. In addition, research performed over the last few years has led to the development of novel therapies and new drug approvals in patients with both newly diagnosed and relapsed/refractory (R/R) AML. Here we discuss the use of these newly approved therapies. Advances in AML have also occurred through development of better tools to assess response to treatment. Both multiparameter flow cytometry and polymerase chain reaction can be used to assess for the presence or absence of measurable residual disease (MRD) and increase the sensitivity of response assessment. The role of MRD assessment is gaining relevance and its integration in clinical trials and treatment decision making will be explored in the second half of this article.

scholarly journals Cutting Edge Molecular Therapy for Acute Myeloid Leukemia

2020 ◽  
Vol 21 (14) ◽  
pp. 5114
Author(s):  
Kenichi Miyamoto ◽  
Yosuke Minami
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Gene Mutations ◽  
Treatment Decision ◽  
Molecular Therapy ◽  
Treatment Decision Making ◽  
Whole Exome ◽  
Therapeutic Development ◽  
Approved Drugs ◽  
Acute Myeloid

Recently, whole exome sequencing for acute myeloid leukemia (AML) has been performed by a next-generation sequencer in several studies. It has been revealed that a few gene mutations are identified per AML patient. Some of these mutations are actionable mutations that affect the response to an approved targeted treatment that is available for off-label treatment or that is available in clinical trials. The era of precision medicine for AML has arrived, and it is extremely important to detect actionable mutations relevant to treatment decision-making. However, the percentage of actionable mutations found in AML is about 50% at present, and therapeutic development is also needed for AML patients without actionable mutations. In contrast, the newly approved drugs are less toxic than conventional intensive chemotherapy and can be combined with low-intensity treatments. These combination therapies can contribute to the improvement of prognosis, especially in elderly AML patients who account for more than half of all AML patients. Thus, the treatment strategy for leukemia is changing drastically and showing rapid progress. In this review, we present the latest information regarding the recent development of treatment for AML.

scholarly journals Challenges in Treating Older Patients with Acute Myeloid Leukemia

2010 ◽  
Vol 2010 ◽  
pp. 1-11 ◽  
Author(s):  
Lagadinou D. Eleni ◽  
Zoumbos C. Nicholas ◽  
Spyridonidis Alexandros
Keyword(s):  
Acute Myeloid Leukemia ◽  
Clinical Judgment ◽  
Myeloid Leukemia ◽  
Treatment Options ◽  
Intensive Therapy ◽  
Treatment Decision ◽  
Social Background ◽  
Therapeutic Approaches ◽  
Appropriate Treatment ◽  
Acute Myeloid

Whereas in younger patients diagnosed with acute myeloid leukemia (AML) treatment is straightforward and the goal is cure, the optimal treatment decision for older adults remains highly controversial. Physicians need to determine whether palliation, “something” beyond palliation, intensive therapy, or an investigational therapy is the most appropriate treatment option. This requires understanding of the biology and risk profile of the AML, clinical judgment in evaluating the functional status of the patient, communication skills in understanding the patient's wishes and social background, and medical expertise in available therapies. The physician has to accurately inform the patient about (a) the unique biological considerations of his leukemia and his prognosis; (b) the risks and benefits of all available treatment options; (c) novel therapeutic approaches and how the patient can get access to these treatments. Last but not least, he has to recommend a treatment. This paper tries to discuss each of these issues.

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