Evaluating Older Patients With Acute Myeloid Leukemia in SIERRA Trial

Apr 08, 2020

Rajneesh Nath, MD, discusses the rationale for phase III SIERRA trial, which evaluated the anti-CD45 monoclonal antibody apamistamab followed by fludarabine/total body irradiation and allogeneic hematopoietic cell transplantation in patients with relapsed/refractory acute myeloid leukemia.

Rajneesh Nath, MD, a medical oncologist at the Banner MD Anderson Cancer Center, discusses the rationale for phase III SIERRA trial, which evaluated the anti-CD45 monoclonal antibody apamistamab (Iomab-B, day-12) followed by fludarabine/total body irradiation and allogeneic hematopoietic cell transplantation (HCT) in patients with relapsed/refractory acute myeloid leukemia (AML).

Patients with AML who have never gone into remission or those who have gone into remission with standard chemotherapy but subsequently relapse tend to have a very poor prognosis. The only cure for these patients, according to Nath, is allogeneic stem cell transplant (SCT), but this is particularly challenging for patients over the age of 55.

Older patients over the age of 55 will initially receive induction chemotherapy, and if they achieve remission, they then undergo SCT. However, the toxicity associated with SCT is high and this patient population does not typically go into remission. Because of this, most of these patients are not offered curative SCT.

The SIERRA trial evaluates the ability of allogeneic HCT to induce remission in patients who are over the age of 55 with relapsed/refractory AML.

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