The thorny issue of relapsed acute myeloid leukemia

Acute myeloid leukemia (AML) is a devastating disease, in which the majority of afflicted patients eventually experience relapse and die from their disease.

Clinical and molecular characterization of the disease have greatly aided in prognostication in both primary and relapsed settings, which may broadly guide therapy, but truly effective standards of care for relapsed AML remain lacking. Traditional chemotherapeutic drugs have modest but limited efficacy in relapsed AML, whereas more novel and potent cytotoxic chemotherapeutic agents hold promise and are entering the advanced phases of testing. Targeted therapies for AML have demonstrated activity, often as single agents, generating enthusiasm for further development in subgroups of patients with appropriate molecular anomalies. Finally, allogeneic stem cell transplantation continues to evolve as an effective and potentially curative therapy for limited numbers of patients with relapsed AML.

The complexity of relapsed AML will dictate the need for continued development of novel chemotherapeutic and targeted therapies that suit the molecular and clinical profiling of individual patients.