In a nutshell
These guidelines aimed to provide the latest guidelines on managing acute myeloid leukemia.
Some background
Acute myeloid leukemia (AML) is the most common form of acute leukemia in adults. Recent advances have led to new treatment options for AML such as targeted therapies and low-intensity regimens.
The National Comprehensive Cancer Network (NCCN) guidelines for AML focus on managing AML and provide recommendations on workup, diagnostic evaluation and treatment options for patients.
Methods & findings
Workup for suspected AML consists of a full medical history and physical examination. Laboratory evaluations of blood count and enzyme levels are carried out. Gene mutation analysis and antigen typing are also carried out.
A diagnosis of AML can be reached if there are 20% or more blasts (young, immature cells) present in marrow or peripheral blood. Multiple diagnostic studies are used to classify AML.
Treatment of AML is divided into induction chemotherapy and post-remission (consolidation) therapy. Induction treatments commonly include chemotherapies such as cytarabine (Cytosar-U) and an anthracycline drug such as daunorubicin (Cerubidine).
It is important that patients emerge from the induction phase ready to receive post-remission therapy. In the post-remission phase, higher-risk patients receive more aggressive treatments including allogeneic stem cell transplantation (alloSCT). AlloSCT is where stem cells from a donor are given to the patient to boost their immune system and replace cells lost due to previous cancer treatments.
Patients with high-risk disease can benefit from hypomethylating agents (HMAs) such as azacitidine (Vidaza) or decitabine (Dacogen). Older patients with AML can also benefit from HMAs combined with venetoclax (Venclexta).
Minimal residual disease (MRD) is the small number of cancer cells that remain after treatment. MRD can be used to determine how successful a treatment is. The role of MRD in AML is under investigation.
The bottom line
These guidelines aimed to provide the latest guidelines on managing acute myeloid leukemia.
Published By :
Journal of the National Comprehensive Cancer Network
Date :
Jun 01, 2019
