Eduardo Rego, MD, PhD, University of São Paulo, Brazil, discusses current research dedicated to improving the outcomes of therapy for patients with acute myeloid leukemia (AML) in middle income countries.

This research “aims to reduce the gap between the outcomes of adult patients with acute myeloid leukemia treated in Latin America compared to the outcomes of those treated in Europe and the [United States,” explained Dr Rego.

Research was presented at the 2024 Annual Society of Hematologic Oncology (SOHO) meeting in Houston, Texas.

Transcript:

Hello, my name is Eduardo Rego. I work for the University of São Paulo in Brazil, and I'll be presenting [ talk] [at the] Society of Hematologic Oncology [meeting] about bringing modern acute myeloid leukemia (AML) therapy to middle income countries. I will present the experience of the International Consortium on Acute Leukemia (ICAL) in the study IC-AML 2015 which aims to reduce the gap between the outcomes of adult patients with acute myeloid leukemia treated in Latin America compared to the outcomes of those treated in Europe and the [United States.] The ICAL has a 15-year-old history.

The first study that we conducted was on acute promyelocytic leukemia (APL) and we have observed a very good long-term result, reducing induction mortality, increasing the overall survival, and establishing infrastructure and a clinical network between 5 countries in Latin America. The IC-AML is a study in which we are aiming to bring modern diagnosis to this region with the support of the Torsten Haferlach [Leukemia Diagnostics] Foundation as well as of the American Society of Hematology (ASH) Foundation, we have established 6 labs for next generation sequencing (NGS) in the region.

With the help of the Erasmus University with Dr Peter Valk, we developed a small set of genetic analysis that would allow us to properly classify patients according to risk. With that, we aim to have those patients with truly favorable prognosis and on the consolidation, treatment-based [regimen with] intermediate dose cytarabine. We avoid allogenic transplant. With that, we would have a smaller waiting list for those patients with unfavorable prognosis and they could proceed to the transplant.

The protocol also included measurable residual disease (MRD). We are currently doing that with the supervision of investigator Dr Sylvie Freeman in the UK to develop a MRD technology based in multi-parameter flow cytometry that would be possible in these countries. We need to assure that the results obtained are reproducible and comparable to those obtained mainly in the UK. These activities have been going on for [about] 5 years now, and the results are very good. We have succeeded to implement both labs per country, which means the lab for molecular analysis and the lab for measurable residual disease.

We are participating in external quality assessment programs [in] the UK [and in the US], which has consistent results showing that the participating labs have improved. This is also accompanied by measures of medical education and other infrastructure initiatives. We are already observing improvement in overall survival, reduction in induction mortality, and we hope that by the end of this study, which aims to enroll a little bit more than 500 patients, we will be able to establish a longstanding network that would finally allow us to have comparable results in terms of the treatment outcome in adult patients with acute myeloid leukemia.

Source:

Rego E. International expansion of modern AML therapy. Presented at the 2024 Society of Hematologic Oncology meeting. September 4-7, 2024. Houston, Texas.