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PART 1 - Background. Vyxeos is the “winner” of the first #oncstewardship #tweetorial! There are some serious flaws in the Vyxeos data. First let’s define Secondary AML (sAML) 
sAML can be divided into AML that has evolved from an antecedent heme disorder (AHD), or therapy-related AML (tAML). Per WHO, AML with myelodysplasia-related changes (AML-MRC) also includes those with MDS-related cytogenetic abnormalities and those with multilineage dysplasia
Classic agents that lead to tAML are:
1⃣XRT/alkylating agents➡️longer time to AML development (5-7 yrs)➡️associated w/ MDS-like monosomal karyotypes (deletion 5 or 7)
2⃣Topo II inhibitors➡️shorter latency (1-3 yrs)➡️associated w/KMT2A rearrangements (MLL, 11q23)
#boardquestion
1⃣XRT/alkylating agents➡️longer time to AML development (5-7 yrs)➡️associated w/ MDS-like monosomal karyotypes (deletion 5 or 7)
2⃣Topo II inhibitors➡️shorter latency (1-3 yrs)➡️associated w/KMT2A rearrangements (MLL, 11q23)
#boardquestion
