Preliminary data from the randomized trial of CPX 351 re induction versus standard re induction therapy was presented at the 2011 ASH Annual Meeting. A recent publication reports the results of the Phase II study of Fostamatinib ic50 plerixafor in conjunction with salvage chemotherapy in relapsed or refractory AML. There was no increased toxicity with the addition of plerixafor, and the CR/CRi rate was 460-mile in this population with a two fold mobilization in leukemic blasts into the peripheral blood. 82 Tigecycline, an antibiotic effective in multi-drug resistant soft-tissue infections, was defined as an inhibitor of mitochondrial translation with in vitro efficacy against leukemia stem and progenitor cells. 83 A phase I study of the agent in relapsed AML is ongoing. 23 Discussion There is no question that far better therapy is required in most of patients with AML. In addition, AML incidence is anticipated to increase with the aging populace, underscoring the necessity for less-toxic regimens in patients with co-morbid circumstances Organism precluding intensive chemotherapy. Potential opportunities for intervention within the traditional AML treatment paradigm occur inside the post remission, induction and relapsed controls. Trials of alternative induction programs are ongoing in both younger and older individuals, as are trials of new agents put into the prevailing 7 3 backbone of AML therapy. Increased molecular profiling of the conditions typically considered AML has provided physicians with an additional prognostic tool and researchers with objectives to pursue in defined populations of people. Practically speaking, this enhanced prognostication has only led to practice changes regarding the utilization of stem-cell transplant for patients expected to get poor outcomes. CTEP 84, 85 Other attempted treatments with FLT 3 inhibitors have thus far led to disappointing clinical results. 67, 68 However, it is likely that important developments will require the design of combinations of personalized therapies on the basis of the genetic mutations underlying a person leukemia. The heterogeneity and further sub classification of AML presents both opportunities and problems for the development and evaluation of novel treatment strategies. It is difficult to collect large numbers of patients with less common sub-types to clinical trials, and frequently detail by detail molecular analysis isn’t available before the initiation of treatment. Article hoc part analyses by age or molecular abnormalities may not be powered to offer strong information displaying benefit for certain sub-types. For instance, GO shows improved overall survival in people that have favorable risk cytogenetics. However, these benefits were not understood in larger randomized trials of all cytogenetic classes, resulting in its withdrawal from the US market. The fate of GO in the US remains unclear, despite increasing evidence of efficacy in a few AML patients from maturing European knowledge.