The management and treatment of acute leukemia (myeloid and lymphoblastic) has undergone major changes in recent years thanks to new treatment options and improved monitoring techniques of the disease, which are allowing personalized treatment algorithms. "We are facing a new scenario and new challenges that mean we have to change our mentality," stresses Dr. Adolfo de la Fuente, head of the Hematology Service at MD Anderson Cancer Center Madrid.
For that reason, the 9th Meeting on Acute Leukemia, organized every year by Dr. De la Fuente of MD Anderson Madrid and Dr. Miguel Angel Sanz, of the Hospital Universitario y Politecnico La Fe, in Valencia, has become even more important in these difficult times.
Dr. de la Fuente points out that in a virtual format "facilitating the participation of attendees and maintaining, as far as possible, the richness of exchanging experiences person to person", the meeting brought together around 600 acute leukemia specialists from 12 different countries, who had the opportunity to share the changes that have taken place in recent years in the approach to the disease.
Because it is an aggressive disease, the traditional approach to acute leukemia had always been to administer treatment for a limited duration in time until the patient went into complete remission of their disease, or not and then, based on that response, the patient's chances of a cure were assessed. A situation that has changed completely because, as Dr. de la Fuente states, "we now have chronic treatment strategies, of indefinite duration while the disease is under control".
Immunotherapy, high-risk AML and FLT3 inhibitors – the protagonists
Among the most interesting topics of the meeting, Dr. de la Fuente highlights, for example, the commercialization in Europe of a treatment option that has shown positive results, superior to those of conventional chemotherapy in the treatment of patients with high-risk myeloid leukemia, where there are significant, as yet unmet, therapeutic needs.
Likewise, also in acute myeloid leukemia, much has been said about FLT3 inhibitors, a mutation appearing in 30% of cases diagnosed with the disease. "In addition to new drugs with this mode of action, we have more and more knowledge about how to apply these treatments with the aim of increasing the percentage of patients achieving remission, thus improving their life expectancy," says Dr. de la Fuente.
Another promising option in the field of acute leukemia is immunotherapy. There are already some approved drugs and, currently, Dr. de la Fuente explains, "enormous progress is being made in the selection of treatment targets and in other strategies aimed at increasing effectiveness and reducing toxicity of the treatment”.
COVID-19 has forced acute leukemia management to be redefined
Coronavirus infection has had a direct impact on the health care of patients around the world and especially in the management of those especially vulnerable to the disease due to their immunosuppressive condition. Because of this, during the meeting, a review was made of the main challenges the Leukemia Units had to face at the beginning of the pandemic and how they worked to minimize its effects on the chances of the patients surviving and being cured.
After the review, congress attendees debated the best way to organize the Leukemia Units now for the short and medium term to continue guaranteeing excellent care for all patients with acute leukemia.