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AML Treatment Path: Deciding What’s Right for You

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Published on February 7, 2020

Key Takeaways

  • A patient’s genomic profile can help determine whether they are a good candidate for transplant.
  • With close monitoring for changes in the disease and MRD status, the best course of care may change over time. 

Expert Dr. Pinkal Desai, from New York Presbyterian-Weill Cornell Medical Center, shares advice for acute myeloid leukemia patients considering a transplant. Watch as Dr. Desai discusses how a person’s genomic profile can indicate whether a person is a good candidate for transplant and the role of minimal residual disease (MRD) testing.

This is a Patient Empowerment Network program produced by Patient Power. We thank Astellas, Celgene Corporation, Daiichi Sankyo and Jazz Pharmaceuticals for their support. These organizations have no editorial control. Patient Power is solely responsible for program content.

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Transcript | AML Treatment Path: Deciding What’s Right for You

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:            

A lot of where you are headed now is who needs what, right? And, transplant being one option, or how you maintain your remission from the transplant, or who, like Jerry, maybe wouldn’t benefit, right?

Dr. Desai:  

That’s absolutely correct. There’s a few things that we take into consideration from a standpoint of a transplant. One is we are predicting based on the cytogenetics and the genomic profile whether someone would be benefiting or not, so there are some people who clearly benefit and some people who clearly don’t benefit, but there are people in the middle—some who are in the intermediate range—where it is a little controversial on whether it’s an absolute indication or not.

So, for Jerry, we had discussed this—whether we should go for a transplant or not—and we made the decision that we would not go for a transplant because he had a particular molecular abnormality that we could monitor and measure the MRD, or the minimal residual disease, so as long as I was keeping an eye on that, I knew that he was in a solid, deep remission over all the course of these five years. 

So, like the same way that we are talking about different treatments, now, transplant decisions—although I agree with Dr. Kadia that transplant is absolutely an important tool in our box for curing patients with leukemia, but how we do transplant, who we choose for transplant, and how we can improve upon transplant both prior to and post-transplant is extremely relevant. 

And, for people who don’t want to go for transplant, there’s new strategies coming along to maintain them, but most important, part of this is to monitor people regularly to make sure that they are indeed in deep remissions and are MRD-negative to make sure that that decision stays correct. So, it’s not a one-time decision. You have to constantly monitor to make sure that path is the right path.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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