Maintenance Therapy for Acute Myeloblastic Leukemia

Abstract

We can define maintenance as low-dose therapy that is administered periodically for a relatively long period of time after having achieved, at least, a morphological response. In the case of acute myeloid leukemia (AML), this concept is relatively new, due to its widespread use that is only a few decades old. Among the various options we have for maintenance in this disease, we have hypomethylating agents (HMAs), target agents and other options such as low-dose chemotherapy. Azacitidine and the CC486 molecule are hypomethylating agents that have approvals for use in maintenance with mixed results. Venetoclax and other target molecules can also be used in conjunction with HMA. The FLT3 molecular alteration is of great importance due to the prognostic factor it represents; its inhibition with specific people is another important branch of maintenance. Patients undergoing transplantation must also undergo some subsequent maintenance with appropriate targets. Maintenance should be the central axis of the management of these patients after completing the different phases of intensive therapy, as it has been shown to improve the medium- and long-term prognosis in the various presentations that this disease has manifested.