Dr. Zelenetz on Treating Hematologic Malignancies

Andrew D. Zelenetz, MD, PhD, Vice Chair, Medical Informatics, Department of Medicine; Chief, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, describes challenges and emerging treatment approaches for patients with hematologic malignancies.

For patients with acute myeloid leukemia (AML), outcomes have not improved for several years, Zelenetz notes. Further research into the underlying biology in AML is necessary, to find molecular targets for the development of novel treatments. In general, AML is far more complex than chronic myelogenous leukemia, which has several novel targeted agents, Zelenetz notes as an example.

Challenges still exist in the treatment of patients with Hodgkin lymphoma, since many late consequences of treatment are still prevalent. Trials are currently trying to identify treatment approaches that use smaller doses, as a means to reduce secondary cancers and cardiovascular disease.

Many exciting new agents have fundamentally impacted the treatment paradigm for patients with multiple myeloma, Zelenetz states. For many years, the standard treatment approach in young healthy patients with multiple myeloma was induction therapy followed by high-dose therapy and autologous stem cell rescue. However, the high remission rates demonstrated by new combination therapies may call for a change in this initial treatment strategy. Similar to non-Hodgkin lymphoma, transplant may be more suitable at the time of relapse, Zelenetz postulates.