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What Is the Treatment Approach for Patients With Secondary AML?

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Published on July 26, 2019

What is the course of care for people who develop secondary acute myeloid leukemia (AML)? AML expert Dr. Uma Borate, from the Oregon Health & Science University, discusses disease presentation, treatment strategy and ongoing clinical research with targeted agents. Watch now to find out more about treatment options for secondary AML.

This is a Patient Empowerment Network program in partnership with The Leukemia & Lymphoma Society produced by Patient Power. We thank Celgene, Daiichi Sankyo, Jazz Pharmaceuticals and Novartis for their support. These organizations have no editorial control.

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Transcript | What Is the Treatment Approach for Patients With Secondary AML?

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.

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.

And to me that is a huge disservice to our AML patients. Because, as you describe, either because you had a prior cancer, let's say you had breast cancer and you had chemotherapy for that breast cancer or lung cancer and you survived it, and so you're a survivor. And 10 years later you develop AML as a result of exposure to prior chemotherapy, which in many ways does things to your stem cells like a pesticide that Don might have been exposed to. 

And so I think the thing that secondary AML has taught us is when a patient develops secondary AML there is a large number of genetic mutations already existing in the patient from their prior chemo, from their prior cancer, from their prior exposures. And so because the treatment is so hard it's something that we're looking about very carefully in the lab to understand it much better.  

And especially about secondary AML from myelofibrosis or these diseases we call MPNs, meaning myeloproliferative neoplasms maybe essential thrombocytosis, polycythemia vera, all these big names.  We have a study here at Oregon Health & Science University which combines our targeted therapy.  You might have heard about it.  It's called Jakafi is the commercial name or ruxolitinib is the pharmaceutical name, and it targets a mutation called JAK or JAK2.  And then we combine it with a chemotherapy we call, just called daunorubicin-cytarabine (Vyxeos), which has also been recently approved specifically for secondary AML.  

And so we're taking that approach I describe where we're combining the therapy that's already on the market for secondary AML and has shown benefit, but then we're adding this targeted agent which is also on the market for myelofibrosis, but they haven't ever been combined together.  But we're doing it in a way that's slow and careful and cautious, because, you know, we have to talk about safety, and we want our patients to get the benefit but not the toxicity.  And we want to see what this does.  The response rates for secondary AML from myelofibrosis are anywhere from zero to 15 percent, which is terrible.  And so we really want to improve on that.  

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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