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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
Acute myeloid leukemia in adults
1Indiana University Cancer Center, RT 473, 535 Barnhill Drive, Indianapolis, IN 46202, USA.
Current Treatment Options in Oncology
|June 12, 2002
Summary
Treatment for acute myeloid leukemia (AML) in adults has poor outcomes. Standard induction therapy involves cytarabine and an anthracycline, with high-dose cytarabine consolidation for remission, while stem cell transplant is for high-risk patients.
Area of Science:
- Hematology
- Oncology
- Clinical Therapeutics
Background:
- Acute myeloid leukemia (AML) in adults has an unacceptable treatment outcome.
- Current induction therapies, including high-dose cytarabine, do not significantly improve remission rates or survival and can be toxic.
Purpose of the Study:
- To outline current evidence-based treatment strategies for newly diagnosed adult acute myeloid leukemia.
- To provide recommendations for induction, consolidation, and salvage therapies, including stem cell transplantation.
Main Methods:
- Review of meta-analyses and clinical trial data regarding induction and consolidation chemotherapy for AML.
- Analysis of data on the role of high-dose cytarabine, anthracyclines, and stem cell transplantation (allogeneic and autologous) in AML treatment.
Main Results:
- Standard induction therapy should include cytarabine with daunorubicin, idarubicin, or mitoxantrone; idarubicin shows a modest benefit.
- Consolidation with high-dose cytarabine is recommended for patients achieving remission.
- Allogeneic stem cell transplant is reserved for poor-risk patients; autologous transplant is not recommended in first remission outside trials.
Conclusions:
- Optimal induction therapy for AML involves cytarabine and an anthracycline, followed by high-dose cytarabine consolidation.
- Stem cell transplantation decisions are risk-stratified.
- Patients with poor-prognosis AML should be considered for clinical trials.
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