Vijay Ramanan
Yashoda Hematology Clinic, Pune, India
Title: Management of acute myeloid leukaemia in elderly and resource constrained setting
Biography
Biography: Vijay Ramanan
Abstract
Currently, only about 20% of Indian AML patients can afford the standard therapy of 7+3 followed by HIDAC. The stem cell transplant option is financially accessible to an even smaller subset. There is a huge unmet need for an affordable treatment option for the vast majority of the population. We believe that our innovative approach of using lenalidomide with cytosine is a viable option for treating a vast majority of patients with elderly AML, relapsed AML financially challenged segments of the population, and brings hope to this neglected demographic. For this underserved demographic subset, we came up with an innovative protocol of Oral Lenalidomide and Subcutaneous Cytosine. We found that: Lenalidomide-Cytosine is an option for the elderly AML patients who are hemodynamically stable. Remission seems to take a longer time - about 60 days. The effects of combining this with traditional options will need more clinical trials to elucidate. The option of adding azacytidine or decitabine is being considered but with lenalidomide alone. Another approach that may be considered is the addition of an intermediate dose cytarabine after achieving remission. Thus, we have tried to summarise treatment options for elderly AML with specific reference to cytosine-lenalidomide combination.