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IACH Focus on Leukemia 2020 | Challenges when treating older leukemia patients

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Didier Blaise

Didier Blaise, MD, PhD, Paoli-Calmettes Institute, Marseille, France, discusses the main challenges when treating older patients with leukemia. Treatment toxicity is a major challenge to overcome, which can be managed with modulation regimes. However, lowering the dose of medication can result in losing some therapeutic benefit. Prof. Blaise highlights the importance of continuing therapy after transplantation, such as immunotherapy or maintenance therapy. This interview took place during the 2020 Annual Meeting of the International Academy for Clinical Hematology (IACH).

Transcript (edited for clarity)

Yes, of course, we meet challenges. Of course, the first challenge is the toxicity, but thanks to the effort we have done with a modulation of the intensity of the conditioning regimen. I think we are in the situation that we are not perfect, we can really be in this field. That’s the first thing, the second thing, and the most important is disease recurrence because usually, we treat disease, the patient present with severe disease, high-risk disease, and we treat the most severe then...

Yes, of course, we meet challenges. Of course, the first challenge is the toxicity, but thanks to the effort we have done with a modulation of the intensity of the conditioning regimen. I think we are in the situation that we are not perfect, we can really be in this field. That’s the first thing, the second thing, and the most important is disease recurrence because usually, we treat disease, the patient present with severe disease, high-risk disease, and we treat the most severe then. So, and because we modulate the intensity of a condition or regimen, we may lose some anti-neoplastic treatment by decreasing disease intensity. So very clearly for this population, their strategy is not to do transplant and we don’t do anything else. We have to consolidate transplantation by giving some treatment after transplantation, it could be immunotherapy, it could be maintenance treatment and it is very important.

So the reality of transplantation means all the patient is the length of time as the duration of the treatment, which is basically six months. And the last point is to be sure that we take into account the reality of this population in order to be sure that this patient can achieve a good quality of life after transplantation.

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