Affordable Access

deepdyve-link
Publisher Website

Management of persistent AML at day 14.

Authors
  • Estey, Elihu
Type
Published Article
Journal
Best Practice & Research Clinical Haematology
Publisher
Elsevier
Publication Date
Jan 01, 2014
Volume
27
Issue
3-4
Pages
235–240
Identifiers
DOI: 10.1016/j.beha.2014.10.004
PMID: 25455272
Source
Medline
Keywords
License
Unknown

Abstract

A common occurrence in management of acute myeloid leukemia (AML) is persistence of disease in the first post-treatment marrow, typically obtained 14-21 days after initiation of therapy. Here we will briefly discuss the prognostic significance of this finding and the relative values of morphology and multiparameter flow cytometry (MPFC) in assessing persistent AML. We will then consider the therapeutic options for persistent AML: (a) repetition of the first course of therapy, most frequently 3 days of daunorubicin or idarubicin followed by 7 days of cytarabine (ara-C) (hereafter "3 + 7"), (b) change to different chemotherapy, often "high-dose ara-C" (HiDAC) +/- other agents, (c) immediate allogeneic hematopoietic cell transplantation (HCT), or (d) HiDAC with HCT done in HiDAC-induced aplasia and using a conditioning regimen other than HiDAC. Since it is generally accepted that response to azacitidine or decitabine requires several months, the remarks here principally apply to patients not given these drugs, but rather given ara-C-containing therapy.

Report this publication

Statistics

Seen <100 times