Optimizing Treatment Methods Among Patients With Newly Diagnosed AML

At the 2024 Lymphoma, Leukemia & Myeloma Congress in New York, New York, Justin Kaner, MD, Weill Cornell Medicine, New York, New York, shares expert insight into various treatment methods to optimize management of patients with newly diagnosed acute myeloid leukemia (AML), including transplant evaluations and timeliness of test results.

Transcript:

Hi, my name is Justin Kaner. I'm the director of the Inpatient Leukemia Service and assistant professor of clinical medicine at Weill Cornell Medicine. I'm here at the Lymphoma, Leukemia and Myeloma meeting in 2024. This morning, I gave a talk on a high-level approach of getting an acute leukemia patient on the right [treatment] track.

As the director of the Inpatient Leukemia Service at Weill Cornell Medicine, I am involved in diagnosing and then taking care and managing acute leukemia patients. One of the things that in my time here over the past 4 and a half years in various roles is that there's efficiencies and optimization in managing patients with newly diagnosed acute leukemia. For example, leukemia emergencies, working in a multidisciplinary team, minimizing toxicities to chemotherapy. I think I was able to present today to our audience and describe our experience and ways that we can work together moving forward from the broader community.

One of the big takeaway points from my discussion was the early referrals for patients who are young with acute leukemia who may need transplant evaluations. Many of our colleagues in community and academic affiliate centers don't necessarily have access to a transplant program. Secondarily, our other high-level point was patients who have leukemia emergencies, for example, acute promyelocytic leukemia, that you have to know at your institution, do you have all-trans retinoic acid [(ATRA)]? And are you able to give those patients that medicine in a timely manner? We know that that saves lives.

One thing I wanted to get out there, which I thought was helpful, and I think colleagues of mine at other centers will find helpful, is that if you do not have access to the transplant program [or] to ATRA, you should not be worried about giving us a call, sending us an email, getting in touch with us about early referrals. Maybe we're not the right center, but we can help in that way.

The last thing I would add is that in our work with our colleagues from hematopathology and cytogenetics, and in rapidly diagnosing and evaluating and starting treatment on patients, [ we have found] that there are ways of optimizing, getting the flow of test results. That includes flow cytometry, cytogenetics, and fluorescence in situ hybridization (FISH) molecular testing like polymerase chain reaction (PCR) testing and AML and next generation sequencing (NGS).

In some of my role as a director of the Inpatient Leukemia Service, I've been able to work with our hematopathologists and cytogeneticists in rushing and optimizing turnaround times on tests. It's not about doing it for every patient all the time, but in patients who need it for clinical trial screening [and] for emergencies where patients are very ill and need a treatment plan immediately. Our teams have been very flexible.

I think a takeaway from this, and what I hope others can take away, is that it's worthwhile at your institution to think about what is possible: what are the turnaround times of your tests, and can you work in a multidisciplinary group to optimize and make things more efficient? That's something that we've learned as a group, and I hope that it was well-received, and I hope people got a lot out of the talk. Thanks for having me.

Source:

Kaner J. AML Clinical Management: Getting a Newly Diagnosed Patient on the Right Path. Presented at Lymphoma, Leukemia & Myeloma Congress; October 16-19, 2023. New York, NY.