Precision medicine and immunotherapeutic approaches for relapsed/refractory paediatric acute myeloid leukaemia

Despite improved clinical outcomes amongst children and adolescents/young adults with acute myeloid leukaemia (AML) treated with modern risk-adapted frontline therapies, approximately one third of patients will relapse. Significant advances in comprehensive cytomolecular genetic diagnostics and correlation with survival outcomes via clinical trial data have identified paediatric patients with AML at highest risk of primary chemoresistance and/or subsequent relapse for whom new treatment approaches are needed. This brief North American-based perspective highlights promising small molecule inhibitors and antibody-based and cellular immunotherapies with demonstrated or emerging activity in specific high-risk subtypes of paediatric AML and outlines potential treatment strategies for children and adolescents/young adults with relapsed AML.