“How I treat” a patient with DNMT3A-mutated AML in remission post intensive chemotherapy

The AML Hub was pleased to speak with Cristina Papayannidis, Universitaria di Bologna, Bologna, IT. We asked, How do you treat a patient with DNMT3A-mutated acute myeloid leukemia (AML) in remission post intensive chemotherapy?

Papayannidis discusses a case of a 67-year-old female with DNMT3A-mutated AML who achieved remission following intensive chemotherapy. Her comorbidities and advanced age make her ineligible for allogenic hematopoietic stem cell transplant (allo-HSCT) and create a need for maintenance therapy options. Papayannidis recalls the key findings from the phase III QUAZAR AML-001 (NCT01757535) study, published by Wei et al. in the New England Journal of Medicine, evaluating oral azacitidine vs placebo in patients with AML ineligible for allo-HSCT. Papayannidis also reviews the post hoc subgroup analysis of this trial presented by Lopes De Menezes at ASH 2023, which evaluated the efficacy of oral azacitidine in various mutational subgroups, to guide her treatment approach. She concludes that, for patients not proceeding to allo-HSCT after chemotherapy, oral azacitidine is an important treatment option that is effective in all subgroups of AML, in particular in those with DNMT3A and SRSF2 mutations.

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What your opinion for those having AML WITH FLT-3 and WT Mutation