Novel and optimized de-intensified induction therapy in acute myeloid leukemia

Acute myeloid leukemia (AML) is a potentially curable haematological malignancy but remains one of the most challenging and expensive haematological malignancy to manage.

In India these challenges are further exacerbated by high incidence of multi-drug resistant infections and a high out of pocket expense that results in a high induction mortality and limited access to therapy for the vast majority of patients with a diagnosis of AML, using a conventional intensive chemotherapy that is offered for this disease in young adults (<60-years).

There is a felt need to introduce and optimize de-intensified induction therapy with limited off-target side effects.

Over the span of two India Alliance Senior Fellowships we have evaluated drug resistance in acute promyelocytic leukemia (APL), a subtype of AML, and in AML.

We have also observed and reported on a unique metabolic vulnerability in AML that can be targeted effectively by re-purposing arsenic trioxide (ATO) and artesunate (ART), an anti-malarial drug. The pre-clinical work has been completed.

The key goal of this project is to translate this potentially efficacious and low cost intervention into standard treatment algorithms for AML through an academic clinical trial and to develop additional novel strategies to predict response to this therapy.