Acute Myeloid Leukemia Treatment

 The medicine Tibsovo contains ivosidenib, a small molecule inhibitor that targets the mutant isocitrate dehydrogenase 1 (IDH1) enzyme. Healthcare professionals recommend Tibsovo 250 mg Tablets in treating patients with acute myeloid leukemia (AML) and cholangiocarcinoma with an isocitrate dehydrogenase-1 (IDH1) mutation. 

Acute Myeloid Leukemia: Blood Cancer

Acute myeloid leukemia (AML) is a rare cancer that affects your bone marrow and blood. It typically happens when certain genes or chromosomes mutate (change). AML usually affects people aged 60 and older but can also affect younger adults and children. 

Types of Acute Myeloid Leukemia are:

Myeloid leukemia: Cancer in cells that produce neutrophils, a white blood cell. Most people with AML have the myeloid leukemia subtype.

Acute monocytic leukemia (AML-M5): Cancer in cells that produce monocytes, white blood cells.

Acute megakaryocytic leukemia (AMLK): Cancer in cells that produce red blood cells or platelets.

Acute promyelocytic leukemia (APL): Cancer in promyelocytes (immature white blood cells) that keeps these cells from developing.

Prevalence

According to the Cleveland Clinic, Acute myeloid leukemia affects about 4 in 100,000 adults annually. Each year about 1,160 children receive an AML diagnosis. 

Symptoms of Acute myeloid leukemia

Early on, AML symptoms may feel like you have a cold or flu that won’t go away. Acute myeloid leukemia is aggressive. That means you quickly develop new and more noticeable symptoms such as:

• Dizziness.
• Easy bruising or bleeding, including frequent nosebleeds and bleeding gums.
• Fatigue.
• Feeling cold.
• Fever.
• Night sweats.
• Frequent infections or infections that don’t go away.
• Headaches.
• Loss of appetite.
• Unexplained weight loss.
• Pale skin.
• Shortness of breath.
• Swollen lymph nodes.
• Weakness.
• Bone, back or abdominal pain.
• Tiny red spots on your skin.
• Wounds or sores that don’t go away.

Diagnosis

Healthcare providers use several tests to diagnose AML, including genetic tests to identify AML type. Providers typically start with a physical examination. 

• Complete blood count (CBC).
• Peripheral blood smear.
• Bone marrow biopsy.
• Spinal tap
• Genetic tests

Treatments

Chemotherapy

There are three phases to chemotherapy for AML — induction, consolidation and maintenance. Some of the chemotherapy medicines for the treatment of AML are:

• Cytarabine
• Daunorubicin 
• Idarubicin 
• Azacitidine 
• Decitabine 
• Glasdegib 
• Venetoclax 

Consolidation therapy

Consolidation therapy kills any remaining cancerous cells. It lowers the risk of cancer recurrence (coming back). Most people receive high-dose cytarabine (Ara-C) or HiDAC five days each month for three or four months.

Maintenance therapy

Chemotherapy drugs for maintenance therapy may include:

• Azacitidine 
• Decitabine 
• Midostaurin 

Targeted therapy

Providers may use targeted therapy to treat AML that’s come back or hasn’t responded to chemotherapy:

Providers may use chemotherapy drugs midostaurin (Rydapt) or gilteritinib (Xospata) to treat AML patients with an FTL3 gene mutation. About 25% to 30% of people with AML carry this mutation.

They may use enasidenib (IDHIFA) or ivosidenib (Tibsovo) to treat people who have AML caused by a mutation of their X gene.