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Adult Acute Myeloid Leukemia Treatment (PDQ®)     
Last Modified: 05/07/2008
Health Professional Version
Changes to This Summary (05/07/2008)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information 1

Added text 2 to clarify the history of myelodysplastic syndromes or another antecedent hematological disorder as among the adverse prognostic factors.

Added text 3 to include fluorescence in situ hybridization as a means of detecting fusion genes formed in t(8; 21) and inv(16).

Classification 4

Added text 5 to include patient preference as a factor on which to base decision to treat.

Added text 6 to state that AML with an FLT3 mutation is not in the WHO classification scheme.

Added text 7 to state that those with 11q23 abnormalities are exceptions in the acute myeloid leukemia with characteristic genetic abnormalities category; also added fluorescence in situ hybridization as a means for detecting translocations.

Treatment Option Overview 8

Added Godwin et al. as reference 12 9.

Added text 9 about the insignificant impact of growth factors on survival in most randomized clinical trials and the less than routine recommendation for their use in the remission induction setting.

Untreated Adult Acute Myeloid Leukemia 10

Added text 11 about older adults who either decline or are unfit for intensive remission induction therapy but who may benefit from low-dose cytarabine; the complete remission rate for the recommended regimen of cytarbine was significantly higher than the remission rate for patients treated with hydroxyurea as was overall survival (cited Burnett et al. as reference 13 and level of evidence 1iiA).

Added bullet 12 to include cytarabine plus mitoxantrone to the list of combination chemotherapy regimens used for remission induction therapy (cited Löwenberg et al. as reference 42).

Adult Acute Myeloid Leukemia in Remission 13

Added Cheson et al. as reference 1 14.

Added text 15 about the lack of improvement in overall survival when compared to chemotherapy-based postremission regimens even though allogeneic bone marrow transplantation has the lowest incidence of leukemic relapse.

Recurrent Adult Acute Myeloid Leukemia 16

Added text 17 about the similarity found in patients who relapse following an allogeneic transplant and undergo a donor lymphocyte infusion (DLI) and patients with relapsing chronic myelogenous leukemia; no published studies of prospective trials examining the role of DLI for patients with acute myeloid leukemia exist. A retrospective European study found a greater number of patients who relapsed after an allogeneic transplant received DLI as part of their salvage therapy and showed significant advantage in overall survival, although the survival advantage might result from selection bias; the remission rate was considerably less than the rate reported for chronic myelogenous leukemia (cited Schmid et al. as reference 22, Dazzi et al. as reference 23, and level of evidence 3iiiA).

Added text 18 about the incorporation of arsenic trioxide into the postremission treatment strategy of de novo acute promyelocytic leukemia patients in clinical trials.



Table of Links

1http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/1.cdr#
Section_1
2http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/2.cdr#
Section_2
3http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/3.cdr#
Section_3
4http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/9.cdr#
Section_9
5http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/112.cd
r#Section_112
6http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/114.cd
r#Section_114
7http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/120.cd
r#Section_120
8http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/46.cdr
#Section_46
9http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/50.cdr
#Section_50
10http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/53.cdr
#Section_53
11http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/293.cd
r#Section_293
12http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/63.cdr
#Section_63
13http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/67.cdr
#Section_67
14http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/190.cd
r#Section_190
15http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/72.cdr
#Section_72
16http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/80.cdr
#Section_80
17http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/302.cd
r#Section_302
18http://cancer.gov/cancertopics/pdq/treatment/adultAML/healthprofessional/86.cdr
#Section_86