Net Guides: Acute Myelogenous Leukemia

OncologyLive, December 2010, Volume 11, Issue 12

Useful Online Resources and Clinical Trials for Acute Myelogenous Leukemia


National Marrow Donor Program: Acute Myelogenous Leukemia Outcomes

This article in the physician information section of the National Marrow Donor Program (NMDP) describes the outcomes of acute myelogenous leukemia (AML) patients who underwent hematopoietic cell transplants from unrelated donors. The NMDP coordinated these transplants from 1998 to 2006 in which marrow or peripheral blood stem cells (PBSC) were used. The page gives outcome sections for 3 different subgroups of patients with AML: adult patients, pediatric patients, and adult patients age 55 and older. For the 2 adult subgroups, outcomes are grouped together based on whether the patient underwent a marrow transplant or a PBSC transplant. All pediatric patients underwent marrow transplants. All patients age 55 and older underwent non-myeloablative transplants for their lessened toxicity, while all patients in the other 2 subgroups underwent myeloablative transplants. Each group of outcomes is displayed in the form of a graph and a chart, which together show the number of transplants and the Kaplan-Meier 5-year survival rate by disease stage. These are accompanied by brief descriptions and some background information.


The Leukemia & Lymphoma Society — AML The Leukemia & Lymphoma Society (LLS) is a voluntary health organization dedicated to finding a cure for leukemia, lymphoma, myeloma, and other blood cancers, and to helping patients with these diseases through information and support. The LLS website has a page devoted to AML information, divided into various topics that are hyperlinked at the top of the page. The first several topics give a basic summary of AML, its causes and risk factors, symptoms, diagnostic tests, and subtypes. The next sections cover general treatment, treatment in children, treatment in older adults,and treatment for special AML subtypes. The page also explains allogeneic stem cell transplantation, autologous stem cell transplantation, disease and treatment side effects, and clinical trials. Visitors can access a number of patient services, including a call center, help finding emotional and financial support, free educational materials, and more.


Level of HOXA5 hypermethylation in AML is associated with short- term outcome

Journal: The Korean Journal of Laboratory Medicine Authors: Kim SY, Hwang SH, Song EJ, et al

Purpose: Hypermethylation of the homeobox (HOX) gene promoter has been found to decrease expression of the gene during tumor development in leukemia. The purpose of this study was to determine whether hypermeth- ylation of the HOX gene promoter may be connected to the clinical outcome. For this study, pyrosequencing was performed to quantify the methylation level of HOXA5 genes in bone marrow samples from 50 patients with AML and 19 healthy controls.

Results: The median methylation percentage of HOXA5 was 65.4% in patients with AML and 43.1% in con- trol patients. Patients with AML with a methylation percentage above 70% had a 3-year overall survival rate of 82.5%, while patients with a methyla- tion percentage of 70% or lower had a 3-year overall survival rate of 40.5%. Cox proportional hazards regression showed that HOXA5 methylation per- centages were independently associ- ated with the 3-year overall survival rate of patients with AML, regardless of karyotypes. The authors concluded that the use of pyrosequencing to quantify HOXA5 methylation may be useful for predicting the short-term prognosis in AML. The authors noted that their study was limited by its small sample size and preliminary nature, and that a larger study should be performed to confirm the results.


Comparing three different combination chemotherapy regimens in treating patients with relapsed or refractory AML

Study Type: Interventional Age/Sex

Requirements: 18-70 years (None)

Sponsor: Eastern Cooperative Oncology Group Identifier: NCT00634244 Purpose: This randomized phase 2 clinical trial will be testing three different combination chemotherapy regimens in the treatment of patients with relapsed or refractory AML in order to determine the effectiveness of each. One arm of the study will be testing carboplatin in combina- tion with topotecan hydrochloride. Another arm will test a combination of alvocidib, cytarabine, and mitoxan- trone hydrochloride. The third arm will test cytarabine with etoposide, mitoxantrone hydrochloride, and sirolimus. The objectives of this study are to determine the complete response rate of each combination chemotherapy regimen, as well as the incidence and severity of toxicity. iivObD


Reduced-intensity conditioning for allogeneic stem cell transplantation in patients with leukemia or lymphoma

Credits: 1.25

Fee: None

Expires: November 9, 2011

This CME activity is based on the latest data concerning the use of allogeneic stem cell transplants with reduced- intensity conditioning in the treatment of patients with non-Hodgkin’s lymphoma and AML. The activity is in a test-and- teach format, modeled after the interactive grand rounds approach, with physicians reading a series of sample cases and answering a question pertaining to each one. After answering each question, participants will be shown the correct answer and given evidence-based information supporting it. There is no penalty for answering the questions incorrectly. On completing the activity, participants should have a better understanding of the benefits and limitations associated with myeloablative conditioning for allogeneic hematopoietic cell transplantation and the rationale for the use of reduced-intensity conditioning. Participants will examine recent research in the use of reduced-intensity conditioning regimens in patients undergoing allogeneic hematopoietic cell transplantation for AML and non-Hodgkin’s lymphoma, and will be able to identify patient and clinical features that can indicate when reduced-intensity conditioning may be appropriate.