Round Table Replay: AML Essentials, Here’s What You Need to Know, Part 3 + Q&A Session

This HealthTree Round Table for AML took place on February 13th, 2023 

Topic: AML Essentials, Here’s What You Need to Know (Part 3 and Q&A Session) 

Experts: Dr. Pamela Becker, City of Hope, Dr. Gabriel Mannis, Stanford, Dr. Dan Pollyea, University of Colorado

Part 3 - Decision Making Strategies with Dr. Dan Pollyea

Here's a recap of Dr. Pollyea's presentation  

Deciding on treatment strategies is a challenge for everyone. How to get to a cure is something that should be considered, even on the first day of diagnosis.

Here are some important insights as a broad overview:

• There are times when a cure is possible with intensive chemotherapy or a transplant so that is important to discuss
• The disease biology and the patient’s fitness are both equally relevant in crafting a treatment strategy, and both of those are not necessarily known on the date of diagnosis

Let’s go step by step:

1. Determine if “good risk” factors exist that would allow a patient to be cured without transplant
2. This may require intensive induction chemotherapy
3. This is uncommon
4. Results should come back within 1-2 days of the bone marrow biopsy

If good risk factors exist, try induction chemotherapy. If they don’t exist, we have to look at age and comorbidities.

Once in remission, a curative action is taken. By this point, full information on each patient’s disease biology obtained at diagnosis should be available. 

Here are some scenarios:

1. If patients have good risk factors and receive induction, then continuation with consolidation therapy is advised
2. If patients don’t have any good risk factors and they are transplant candiates, then go for the transplant
3. If patients don’t have good risk factors and they are NOT candidates for transplant, then continue treatment until progression or intolerance

Remember to be informed, and don’t be afraid to ask for other opinions or inquire about the experience your team has in AML. Also consider requesting a formal consultation, a second opinion or even an inpatient transfer to a higher volume center. And last but not least: quality of life is a priority for every patient, so a balance between side effects/toxicity, treatment, and emotional/psychological situation is always important.

Part 4 - Q&A Session with the Audience

Questions

• 0:27: Can you please explain TP53 mutation?
• 5:42 Do certain food accelerate or slow the progression of the disease?
• 9: 20 How do you define a cure? 
• 14:42 Could you comment on the variations and changes underway between hospital vs. outpatient based treatment?
• 16:44 How does the quality of life change after transplant? What’s the best way to get strength back after it?
• 18:44 What is the physical status after transplant? 
• 21:59 Can you talk about average life expectancy in the present time?

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