Rajneesh Nath, MD, on the Evolution of Treatment for AML in Patients Who Are Elderly

Rajneesh Nath, MD, of the Banner MD Anderson Cancer Center, joins Chadi Nabhan, MD, MBA, FACP, host of The HemOnc Pulse, at the Eleventh Annual Meeting of the Society of Hematologic Oncology to discuss the evolution of treatment for acute myeloid leukemia (AML) in patients who are elderly.
Dr. Nath spoke about the current treatment approaches in patients with AML who are elderly and emphasized the need to include this patient population in clinical research.
“I think it’s really important that we have trials for our elderly patients,” he said.
Dr. Nath, who presented data at from the randomized phase III SIERRA study of Iomab-B in elderly patients with relapsed or refractory AML at this year’s SOHO Annual Meeting, highlighted key findings. The study showed that patients who experienced failure of targeted therapies, including venetoclax, were able to receive allogeneic hematopoietic stem cell transplantation (HSCT) with the Iomab-B-led regimen.
“This is a very tough population to treat, because normally you will not treat or even transplant patients who are refractory,” Dr. Nath said.
He spoke about the implications of these findings and how they may “offer a lot more elderly patients the ability to undergo allogeneic transplant.”
Dr. Nabhan and Dr. Nath also discussed how to approach treatment for patients with AML while waiting for molecular testing results that will inform targeted therapy approaches.
“I look at AML patients in two categories,” Dr. Nath said. “For one, you can easily wait, and another group of patients, that is a group of patients who have a very high white count, who have a high blast count, and you are concerned by waiting, they are going to get leukostasis. You have to give them something. One may consider giving these patients something to reduce their white counts.”
Dr. Nath also highlighted results from another study he presented during the Eleventh Annual Meeting of SOHO. Dr. Nath and colleagues showed that using cyclophosphamide-based prophylaxis for graft-versus-host disease after allogeneic HSCT was safe and effective in patients over 70 years old.