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Management of Acute Myeloid Leukemia: A Review for General Practitioners in Oncology
Ryan J Stubbins1,2, Annabel Francis3, Florian Kuchenbauer1,2,4
1Leukemia/BMT Program of British Columbia, Vancouver Coastal Health, BC Cancer, Vancouver, BC V5Z 1M9, Canada.
Abstract:
Acute myeloid leukemia (AML) is a hematologic malignancy that most frequently develops in older adults. Overall, AML is associated with a high mortality although advancements in genetic risk stratification and new treatments are leading to improvements in outcomes for some subgroups. In this review, we discuss an individualized approach to intensive therapy with a focus on the role of recently approved novel therapies as well as the selection of post-remission therapies for patients in first remission. We discuss the management of patients with relapsed and refractory AML, including the role of targeted treatment and allogeneic stem cell transplant. Next, we review non-intensive treatment for older and unfit AML patients including the use of azacitidine and venetoclax. Finally, we discuss the integration of palliative care in the management of patients with AML.
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