Utilizing Menin Inhibitor Therapy for Patients With Relapsed Acute Myeloid Leukemia
At the 2025 Lymphoma, Leukemia & Myeloma (LL&M) Winter Symposium in Miami, Florida, Sangeetha Venugopal, MD, Sylvester Comprehensive Cancer Center, University of Miami Hospital, Miami, Florida, discusses considerations when using menin inhibitor therapy for treating patients with relapsed acute myeloid leukemia (AML).
Transcript:
Hi, I'm Sangeetha Venugopal. I'm an assistant professor of medicine in the division of hematology at the Sylvester Comprehensive Cancer Center. My focus is on mainly acute myeloid leukemias and myelodysplastic syndromes (MDS).
We are quite excited about the new kid in the block, which is the menin inhibitor. The drug that is the currently approved menin inhibitor is revumenib . It is approved in the setting of relapsed/refractory KMT2A-rearranged AML, both in infants and adults. This is a pretty new approval that happened in December of 2024, so people do not have much experience with using this drug.
One thing I would point out is the class effect of the menin inhibitors, which is differentiation syndrome. When people are considering the use of menin inhibitors in patients with KMT2A-rearranged AML, they should pay attention to the white blood cell count. If the white blood cell count is higher than 20,000, they should make sure that the patient's white count comes down by cytoreduction using either hydroxyurea or steroids to make sure that they don't land in the hot water of differentiation syndrome.
Because the differentiation syndrome can be quite concerning. It could range from mild to serious, and it could sometimes be even fatal. The studies that reported the results of some of the menin inhibitors has recorded fatalities due to differentiation syndrome. This is something I would encourage the leukemia physicians to pay close attention to when they're thinking about starting revumenib as a treatment option.
Source:
Venugopal S. Updates in Relapsed Acute Myeloid Leukemia. Presented at Lymphoma, Leukemia & Winter Symposium; February 7-9, 2025. Miami, Florida.
