Relapsed Acute Myeloid Leukemia: Need for Innovative Treatment Strategies to Improve Outcome

Relapse remains a major obstacle in improving outcomes of patients with AML. Increased understanding of the molecular aberrations leading to the pathogenesis of AML is providing us with several target specific drugs. Future strategies combining chemotherapy with these drugs are likely to lead to better outcomes. Relapse continues to be a major hurdle in achieving cure in patients with acute myeloid leukemia (AML). The outcome after relapse is not uniform in all patients with AML and is dependent on several prognostic variables, including age, cytogenetics at initial diagnosis, duration of first complete remission, whether an allogeneic stem cell transplant was performed during first complete remission, and the presence of a number of molecular aberrations. Despite extensive research over the past several decades, there is no standard of care for treating patients with relapsed AML. This is possibly due to the accrual of patients with widely different disease profiles in most trials for relapsed AML. With increasing insights into the disease biology based on identification of pathogenic and aberrant molecular and cellular pathways, novel therapeutic strategies are emerging. Hopefully in the near future, we can improve the outcome of patients with relapsed AML with treatment strategies based on identification of specific targets and methods to overcome these aberrant processes. (C) 2015 Elsevier Inc. All rights reserved.