Time to define and refine maintenance strategies in acute myeloid leukaemia

Maintenance therapy aims to reduce the risk of relapse using a non-toxic regimen after remission. After decades of exploration, oral azacitidine remains the only maintenance therapy that improves overall survival and relapse-free survival in patients aged 55 years or older with acute myeloid leukaemia.1 Maintenance therapy with subcutaneous azacitidine has been investigated in a similar setting showing substantial improvements in disease-free survival but not overall survival.2 Despite these efforts, relapse is inevitable in most patients, fuelling the need for better strategies.