Annals of Hematology

, Volume 98, Issue 11, pp 2467–2483 | Cite as

Update on management and progress of novel therapeutics for R/R AML: an Iberian expert panel consensus

  • Pau MontesinosEmail author
  • Juan Bergua
  • Joana Infante
  • Jordi Esteve
  • José Eduardo Guimaraes
  • Jordi Sierra
  • Miguel Ángel Sanz
Review Article


A significant proportion of adult patients with acute myeloid leukemia (AML) fail to achieve complete remission or will relapse later on after achieving it. Prognosis for relapsed or refractory (R/R) AML patients remains discouraging, with the main curative option still relying on hematopoietic stem cell transplant (HSCT) for those who are eligible. Beyond morphological bone marrow and peripheral blood assessment, evaluation of patient performance status and comorbidities, as well as genetic/molecular characterization, is crucial to make an accurate diagnosis and prognosis, which will be useful to select the most appropriate treatment. Emerging strategies are mainly focusing on the development of immune- and molecular-based approaches. Novel targeted therapies are generally well tolerated, potentially allowing them to be administered alone or in combination with classical chemotherapy agents. Enrolment in clinical trials should be considered first option for R/R AML patients, either as a bridge to HSCT or to benefit from novel therapies that eventually may prolong survival and improve quality of life. An Iberian expert panel has reviewed the recent advances in the management of R/R AML with the aim to develop updated evidence and expert opinion-based recommendations.


Acute myeloid leukemia Relapsed Refractory Treatment Targeted therapies 


Author contributions

The authors met the criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE). The authors were fully responsible for all content and editorial decisions, were involved at all stages of manuscript development and approved the final version that reflects the authors’ interpretations and conclusions.

Funding information

Financial support for medical editorial assistance, copyright permission and publication costs was provided by Daiichi Sankyo, Inc., a member of the Daiichi Sankyo Group.

Compliance with ethical standards

Conflict of interest

PM has received research funding from Teva, Celgene, Janssen, Novartis, Daiichi Sankyo, Pfizer and Karyopharm; has received honoraria from Teva, Celgene, Janssen, Novartis, Daiichi Sankyo, Pfizer and Incyte; and has served in a consulting or advisory role for Teva, Celgene, Janssen, Novartis, Daiichi Sankyo, Pfizer, Karyopharm, Incyte and Abbvie. JS has received research funding from Novartis and Amgen; has received honoraria from Novartis, Abbvie, Pfizer, Daiichi Sankyo and Astellas; and has served in a consulting or advisory role for Novartis, Abbvie, Pfizer, Daiichi Sankyo, Gilead, Astellas, Celgene and Roche. JS is a member of DMC from Gamida Cell. JI has received honoraria from Novartis and Daiichi Sankyo, and has served in a consulting or advisory role for Daiichi Sankyo. JE has received research funding from Celgene and Novartis; has received honoraria from Celgene, Janssen, Novartis, Daiichi Sankyo and Astellas; and has served in a consulting or advisory role for Celgene, Janssen, Novartis, Pfizer, Daiichi Sankyo, Jazz Pharmaceuticals, Abbvie, Roche, Teva and Incyte. JEG has received a speaker honorarium (speaker’s fees) from Abbvie, Amgen, Janssen, Pfizer and Daiichi Sankyo; and has served in a consulting or advisory role for Abbvie, Pfizer, Roche and Daiichi Sankyo.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Hematology DepartmentHospital Universitari I Politècnic La FeValenciaSpain
  2. 2.CIBERONCInstituto de Salud Carlos IIIMadridSpain
  3. 3.Division of Hematology/OncologyHospital San Pedro AlcántaraCáceresSpain
  4. 4.Serviço de Hematologia e Transplantação de Medula ÓsseaHospital de Santa Maria, Centro Hospitalar de Lisboa NorteLisbonPortugal
  5. 5.Department of HematologyIDIBAPS, Hospital ClinicBarcelonaSpain
  6. 6.Serviço de Hematologia ClínicaCentro Hospitalar Universitário de São JoãoPortoPortugal
  7. 7.Hematology Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau and Jose Carreras Leukemia Research InstitutesAutonomous University of BarcelonaBarcelonaSpain

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