ACUTE LEUKEMIA CRITERIA CHANGES TO HELP PATIENTS, DOCTORS
Columbus, Ohio – For the first time in 14 years, doctors are changing the measures they use to diagnose acute myeloid leukemia (AML) and to describe how patients respond to treatment.
The new guidelines, published in the Dec. 15 issue of the Journal of Clinical Oncology, incorporate for the first time genetic and molecular abnormalities that help give rise to the disease. They also incorporate the World Health Organization definition of acute leukemia, which means some patients will receive treatment sooner.
Testing for the so-called genetic and molecular markers can help doctors identify the most effective treatment for AML patients. They also can help determine with greater certainty how long a patient might remain in remission following treatment and, in some cases, whether additional treatment might extend a remission.
“These new guidelines should raise the standard of care for people with acute leukemia everywhere, not just at academic medical centers,” says senior author Clara D. Bloomfield, the William G. Pace III Professor of Cancer Research and Cancer Scholar and Senior Advisor at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.
In addition, the new guidelines establish standards for reporting the results of clinical trials testing new treatments for AML by the large, national clinical cooperative groups that conduct such studies.
“Right now, investigators at different centers have their own definition of complete remission, recurrence-free survival and overall survival,” Bloomfield says. “These guidelines establish uniform criteria for these outcomes and should allow us to compare the findings of different therapies far more effectively.
Last, the new guidelines recommend that newly diagnosed AML patients have some of their leukemic cells frozen to preserve the original genetic and molecular changes that led to their type of AML.
Pharmaceutical companies are expected to develop new drugs that target the genetic and molecular abnormalities in AML. A patient’s preserved cells could then be used to help predict whether some future molecularly targeted therapy will help that person should he or she need further treatment.
“Having such cells available will help us learn more about leukemia and help in the development of molecularly targeted therapies,” Bloomfield says. “But it also may be important for the individual patient if a molecularly targeted therapy comes along that can help that person.”
The new guidelines also incorporate the World Health Organization definition of AML. This change lowers the number of cells needed for a diagnosis of AML from 30 percent of immature cells in a sample of blood or bone marrow cells to 20 percent.
“This means certain patients will receive treatment for AML sooner,” Bloomfield says. Formerly, these patients were diagnosed as having “refractory anemia with excess blasts in transformation.”
AML occurs when bone marrow stem cells become cancerous and crowd the bone marrow with immature, malignant white blood cells. The new guidelines were developed by an international working group of leukemia specialists who met in Madrid, Spain, March 2001.
Contact: Darrell E. Ward, (614) 293-3737; Wardemail@example.com