In this discussion, the focus is on optimizing Acute Myeloid Leukemia (AML) treatment. The idea of reducing drug doses upon achieving remission is challenged, questioning its efficacy against resistant disease. The notion of increasing drug doses to target resistance for improved outcomes is proposed. Perspectives diverge, with one side highlighting the need for conservative dosing to manage toxicities, while the other suggests early, aggressive intervention.
A total therapy approach is advocated, emphasizing prompt, intense treatment. Immunotherapies like NK cell engagers and dual CAR-T therapy are explored for lower disease burdens. The potential of combining CAR-T targets, such as CD33 and CD123, is discussed. Sequential therapies involving venetoclax, immunomodulation, and transplantation are considered for enhanced efficacy.