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Clinical Burden and Management of Acute Myeloid Leukemia in the Middle East: Is the System Ready for Precision Medicine?

Marashi M1*, Awidi A2 , Rustmani AA3 , Alhuraiji A4 , Otaibi AA5 , Mahrezi AA6 , Alshehri B7 , Abdulmajeed B8 , Nasar B6 , El-hemaidi E9 , Soliman H10, Yaseen HA11, Motabi I12, Cheikh JE13, Alnahedh M14, Al-Khabori M15, Alzahrani M16, Khudair NA17, Blooshi SA18, Alwesadi T19, Al-Shaibani Z20

Advances in understanding AML's genetic mechanisms have transformed patient management and prognosis. However, implementing precision medicine in the Middle-East faces significant challenges in clinical practice and healthcare systems. Therefore, a panel of 21 experts from the Middle-East held two meetings to highlight AML burden in the region and the current management practice for intensive chemotherapy-ineligible patients. Views on the challenges and accessibility of molecular profiling and targeted therapy were discussed, alongside clinical pharmacists’ role in addressing these challenges. They highlighted that the current local data underestimate the disease burden; thus, a national and unified registry for AML cases is recommended. Despite the recent improvement in the referral system for leukemic cases, many challenges still exist, including referral delay, access to tertiary centers, the accessibility to molecular testing and novel agents’ availability within the market. The targeted therapies’ impact on quality-of-life and indirect treatment costs should be considered critical in the value evaluation of increasing accessibility to novel molecules and diagnostic tools. They also highlighted that clinical pharmacists’s role is limited in ensuring the concordance between molecular test results and treatment plans. In the Middle-East, there is a need for clinical pharmacists’ involvement in the multidisciplinary decision-making process of AML cases.