Treatment of refractory and relapsed acute myelogenous leukemia

Refractory and relapsed disease occurs in most acute myelogenous leukemia patients. Salvage chemotherapy offers a 30-70% chance of a second complete remission. Unfortunately, this second remission is usually short lived and salvage chemotherapy is rarely curative. Allogeneic bone marrow transplant, either human leukocyte antigen (HLA)-sibling matched or matched unrelated donor, is the only treatment to offer long-term disease-free survival and possible cure. Many patients will be ineligible for allogeneic bone marrow transplant. A conjugated antiCD33 monoclonal antibody, gemtuzumab ozogamicin, has recently been approved for use in relapsed and refractory acute myelogenous leukemia patients. New and novel agents are also undergoing trials in an attempt to improve on the overall poor outcomes.