Acute myeloid leukemia: 2014 update on risk-stratification and management

Am J Hematol. 2014 Nov;89(11):1063-81. doi: 10.1002/ajh.23834.

Abstract

Evidence suggests that even patients aged 70 or above benefit from specific AML therapy. The fundamental decision in AML then becomes whether to recommend standard or investigational treatment. This decision must rest on the likely outcome of standard treatment. Hence we review factors that predict treatment related mortality and resistance to therapy, the latter the principal cause of failure even in patients aged 70 or above. We emphasize the limitations of prediction of resistance based only on pre-treatment factors and stress the need to incorporate post-treatment factors, for example indicators of minimal residual disease. We review various newer therapeutic options and considerations that underlie the decision to recommend allogeneic hematopoietic cell transplant.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Allografts
  • Antibodies, Monoclonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cause of Death
  • Chromosome Aberrations
  • Combined Modality Therapy
  • Disease Management
  • Drug Resistance, Neoplasm
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Karnofsky Performance Status
  • Leukemia, Myeloid, Acute / drug therapy
  • Leukemia, Myeloid, Acute / epidemiology
  • Leukemia, Myeloid, Acute / genetics
  • Leukemia, Myeloid, Acute / therapy*
  • Mutation
  • Neoplasm Proteins / genetics
  • Neoplasm, Residual
  • Patient Selection
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Survival Rate
  • Therapies, Investigational
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Neoplasm Proteins