Recurred. How does this change my treatment choices, and are new targeted therapies using biomarkers (BCR-ABL, FLT3)...

I'm sorry to hear your Leukemia has recurred. This can be a challenging situation, but there are treatment options available that may be helpful.

According to the National Comprehensive Cancer Network (NCCN) Guidelines for Acute Myeloid Leukemia, when Leukemia recurs, the treatment approach often shifts to using targeted therapies based on specific biomarkers or genetic mutations identified in the cancer cells. [1]

For example, the NCCN recommends testing for the BCR-ABL and FLT3 mutations, as the presence of these can guide the use of tyrosine kinase inhibitors (TKIs) like imatinib, dasatinib, or ponatinib. [1] The American Cancer Society also notes that these targeted therapies have shown improved outcomes compared to traditional chemotherapy in certain Leukemia subtypes. [2]

Additionally, the Leukemia & Lymphoma Society highlights that newer immunotherapies targeting CD19, CD20, or CD33 may be options for relapsed/refractory Leukemia. These can be used alone or in combination with other treatments. [3]

The specific treatment plan will depend on factors like your disease subtype, prior treatments, overall health, and personal preferences. I would strongly recommend discussing all of these options in detail with your oncology team to determine the best next steps for your care. They can provide personalized guidance based on your unique situation.

Please don't hesitate to reach out if you have any other questions. Wishing you all the best as you navigate this next phase of your Leukemia journey.

Sources: [1] NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia. Version 3.2022. National Comprehensive Cancer Network. [2] "Targeted Therapy Drugs for Acute Myeloid Leukemia." American Cancer Society, www.cancer.org/cancer/acute-myeloid-leukemia/treating/targeted-therapy.html. [3] "Relapsed or Refractory AML." Leukemia & Lymphoma Society, www.lls.org/leukemia/acute-myeloid-leukemia/treatment/relapsed-or-refractory-aml.