Cytogenetic Testing

How Many of Your Patients are High Risk?*1,2

Cytogenetic testing is an important step in the diagnosis, prognosis, and risk stratification of patients with acute myeloid leukaemia (AML).3,4 It also plays a key role in predicting how well a patient will respond to treatment, helping you shape their therapeutic options3,4

The evolving AML treatment landscape

With a growing number of therapeutic options, making optimal treatment decisions for the individual has become increasingly complex.3
That’s where cytogenetic testing can help4

Learn more with Prof. Nigel Russell

Waiting for cytogenetic test results before assigning stable patients to the most suitable treatment is a reasonable approach5-7

Waiting to receive cytogenetic test results before assigning an intensive therapeutic regimen to clinically stable patients is supported by the outcomes from a study of the relationship between time from diagnosis to treatment (TDT) and prognosis on a large set of real-world data from the AML registry of the Study Alliance Leukemia6

Overall survival (OS) according to TDT in all patients (N=2,263)6

Overall survival (OS) according to TDT in all patients (N=2,263)<sup>6</sup>

Multivariable analyses showed:

TDT did not affect the likelihood of complete remission (CR)/CR with incomplete platelet or neutrophil recovery (CRi), early mortality, or long-term OS6

See OS in patients ≤60 years6
See OS in patients >60 years6
See CR/CRi and early death results across patient groups6

 

In the study:6

– 96.6% of patients received daunorubicin cytarabine (DA) 3+7, 2.7% were treated with high-dose cytosine arabinoside and mitoxantrone, and 0.7% with high-dose cytarabine/intermediate-dose cytarabine
– 75% had de novo AML, 15.1% had secondary AML (s-AML), and 9.9% had therapy-related AML (t-AML)

Guidelines recommend selecting treatment according to the patient’s disease and cytogenetic profile3,5,8

Adapted From the Greater Manchester Cancer Haemato-Oncology Pathway: Guidelines for the Management of Acute Myeloid Leukaemia8

flowchart flowchart

This schematic relates to the selection of intensive chemotherapy

Vyxeos Liposomal is indicated for the treatment of adults with newly-diagnosed t-AML or AML-MRC.10 See more here.

Bristol case study:
routine use of cytogenetics

A close professional relationship between the laboratory and clinical team at University Hospitals Bristol NHS Foundation Trust enables the rapid turn around of molecular and cytogenetic test results. It is standard practice at the Trust to wait for and use those results to direct therapy from the beginning, tailoring treatment according to prognostic need

Dr Priyanka Mehta, Dr Rachel Protheroe and Dr Chris Wragg provide an insight into their way of working

Disclaimer: This treatment approach is subject to the physician’s discretion and may depend on the patient’s individual condition and circumstances.

Clinically stable AML patients can wait for cytogenetic test results

Before they are prescribed the optimal treatment for their cancer3-6

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FOOTNOTES

*High-risk AML is defined as therapy-related AML or AML with myelodysplasia-related changes.

ABBREVIATIONS

AML, acute myeloid leukaemia; CI, confidence interval; CR, complete response; CRi, CR with incomplete platelet or neutrophil recovery; MDS, myelodysplastic syndrome; MRC, myelodysplasia-related changes; OS, overall survival; s-AML, secondary AML; t-AML, therapy-related AML; TDT, time from diagnosis to treatment.

REFERENCES
  1. Lancet JE, et al. J Clin Oncol 2018;36(26):2684–2692
  2. Ostgard LS, et al. J Clin Oncol 2015;33(31):3641–3649
  3. NICE Pathway. Myeloid Leukaemia. Available at: pathways.nice.org.uk/pathways/blood-and-bone-marrow-cancers/myeloid-leukaemia Last accessed, June 2022
  4. Hastings RJ, et al. Eur J Hum Genet 2016;24(1):6–13
  5. Tallman M, et al. J Natl Compr Canc Netw 2019;17(6):721–749
  6. Röllig C, et al. Blood 2020;136(7):823–830
  7. Bertoli S, et al. Blood 2013;121(14):2618–2626
  8. Thomas-Dewing R, et al. Greater Manchester Cancer Haemato-Oncology Pathway: Guidelines for the management of acute myeloid leukaemia. Version 3.0, March 2019
  9. Arber DA, et al. Blood 2016;127:2391–2405
  10. Vyxeos Liposomal Summary of Product Characteristics. Available at: https://www.medicines.org.uk/emc/product/9442

ADVERSE EVENTS REPORTING

Adverse events should be reported. For the UK, reporting forms and information can be found at: https://yellowcard.mhra.gov.uk/

For the Republic of Ireland, reporting forms and information can be found at: https://www.hpra.ie/homepage/about-us/report-an-issue

Adverse events should also be reported to Jazz Pharmaceuticals by phone: +44 8081890387 (UK toll-free) or +353 1 968 1631 (Republic of Ireland).

UK-VYX-2100160 l June 2022