What therapy would you give to an AML patient with induction failure while awaiting HSCT?

I generally think of induction failure like relapse. You know you are dealing with chemoresistant disease so something from the "salvage" menu is appropriate. One of the most promising treatments to come along for relapsed/refractory disease in a long time is CPX-351 (Vyxeos). This was studied by the COG in AAML1421 and published recently in JCO by Cooper et al., PMID 32401633. Even patients who did not respond to standard dauno/cytarabine responded to this liposomal formulation. You can combine it with a dose of GO as is being done in the current COG study for de novo patients (AAML1831). The second cycle of AAML1421 was FLAG. This fludarabine/cytarabine regimen is versatile, too. Instead of G-CSF, you can "prime" with an epigenetic agent ...