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Managing AML

Current AML treatment landscape

Waiting for genetic and laboratory test results prior to initiating treatment may ensure that patients are given the best treatment option.1,2 In newly diagnosed AML patients, evidence shows that the time from diagnosis to treatment does not affect long-term survival.

Treatment of acute leukemia is divided into induction chemotherapy (intensive for eligible patients; lower intensity for those ineligible for intensive induction) and post-remission therapy (consolidation therapy)3
While remission is always the goal of therapeutic treatment, it is important for patients to tolerate subsequent treatments to achieve disease control3
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Chemotherapy involves the use of a planned sequence of treatments4

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Consolidation therapy is given to patients who achieve complete remission after chemotherapy4

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Allogeneic hematopoietic-cell transplantation (HCT) is used to treat AML and offers the strongest antineoplastic therapy option4

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Hypomethylating agents (HMA) such as azacitidine and decitabine are options that can be used to treat patients ineligible for intensive chemotherapy5

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Advances in targeted therapies have progressed with developments in research into the biology of the disease6

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For some patients, participation in clinical trials may provide the best path forward7

Patients with MDS/AML should be eligible for both MDS and AML clinical trials, which may inform treatment selections for these patients.8
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AML, acute myeloid leukemia; IC, induction chemotherapy; IDH1, isocitrate dehydrogenase-1; MDS, myelodysplastic syndromes.

References: 1. Röllig C, Kramer M, Schliemann C, et al. Does time from diagnosis to treatment affect the prognosis of patients with newly diagnosed acute myeloid leukemia? Blood. 2020;136(7):823-830. doi:10.1182/blood.2019004583 2. Sekeres MA, Elson P, Kalaycio ME, et al. Time from diagnosis to treatment initiation predicts survival in younger, but not older, acute myeloid leukemia patients. Blood. 2009;113(1):28-36. doi:10.1182/blood-2008-05-157065 3. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.4.2023. © National Comprehensive Cancer Network, Inc. 2023. All rights reserved. Accessed August 14, 2023. To view the most recent and complete version of the guideline, go online to NCCN.org. 4. Döhner H, Weisdorf DJ, Bloomfield CD. Acute myeloid leukemia. N Engl J Med. 2015;373(12):1136-1152. doi:10.1056/NEJMra1406184 5. Tawfik B, Sliesoraitis S, Lyerly S, et al. Efficacy of the hypomethylating agents as frontline, salvage, or consolidation therapy in adults with acute myeloid leukemia (AML). Ann Hematol. 2014;93(1):47-55. doi:10.1007/s00277-013-1940-9 6. Perl AE. The role of targeted therapy in the management of patients with AML. Hematology Am Soc Hematol Educ Program. 2017;2017(1):54-65. doi:10.1182/asheducation-2017.1.54 7. Clinical trials: acute myeloid leukemia. Leukemia & Lymphoma Society. Accessed August 14, 2023. https://www.lls.org/leukemia/acute-myeloid-leukemia/treatment/clinical-trials 8. Arber DA, Orazi A, Hasserjian RP, et al. International consensus classification of myeloid neoplasms and acute leukemias: integrating morphologic, clinical, and genomic data. Blood. 2022;140(11):1200-1228. doi:10.1182/blood.2022015850