Relapsed and Refractory Acute Myeloid Leukemia.

Despite effective initial therapy, the majority of adults with acute myeloid leukemia (AML) who achieve a complete remission (CR) eventually relapse and usually within 2 years. Furthermore, approximately 20% of patients never achieve first complete remission (CR1). In these settings, alternative treatment strategies have limited efficacy and allogeneic hematopoietic stem cell transplantation (HSCT), with generation of the potent immunologic reaction graft-vs.-leukemia (GVL) effect, is considered the best curative strategy. However, many patients do not have a suitable donor or are not candidates for transplantation. Therefore, the treatment of patients who relapse or are refractory to conventional initial therapy is challenging. The definition of refractory AML includes patients who fail conventional induction chemotherapy, those with a short (less than 6-12 months) CR1 duration, and patients who have relapsed twice or more [1]. This definition has been useful in defining relatively uniform populations of patients for clinical trials. [ABSTRACT FROM AUTHOR]