Pretreatment Evaluation

There are several things to consider before determining a treatment for your patients with acute myeloid leukemia (AML).

Fertility Counseling, if Appropriate1

  • Women of reproductive age should be encouraged to discuss future childbearing goals and be counseled about the risks of their cancer treatment to their fertility pretreatment1
  • Benefits to quality of life have been shown for patients who are referred to a reproductive endocrinologist pretreatment1

Dental Evaluation2

  • Oral complications of chemotherapy depend on the drugs used, dosage, degree of dental disease, and whether the patient used radiation
  • Chemoradiation therapy carries a significant risk for mucositis

Management With Medical Team3,4

  • Collaboration with medical specialists to manage comorbidities, including cardiac, vascular, and diabetic comorbidities, may improve survival

MUGA Scan or Echo5

  • National Comprehensive Cancer Network (NCCN) guidelines recommend the evaluation of myocardial function (MUGA scan or echocardiogram) in patients with a history or symptoms of cardiac disease, prior exposure to cardiotoxic drugs, or radiation to the thorax

HLA Typing for HST Candidates5

  • NCCN guidelines recommend human leukocyte antigen (HLA) typing for patients with potential for a future hematopoietic cell transplantation (HCT), except for patients with a major contraindication to HCT

References: 1. Letourneau JM, Ebbel EE, Katz PP, et al. Pretreatment fertility counseling and fertility preservation improve quality of life in reproductive age women with cancer. Cancer. 2012;118(6):1710-1717. 2. National Institute of Dental and Craniofacial Research. Dental Provider’s Oncology Pocket Guide. National Institutes of Health. https://www.nidcr.nih.gov/sites/default/files/2017-09/oncology-guide-dental-provider_0.pdf. Reprinted September 2009. Accessed January 29, 2019. 3. Sorror ML, Storer BE, Elsawy M, et al. Impact of comorbidities at diagnosis for acute myeloid leukemia on one-year mortality. Blood. 2015;126(23):532. 4. Abdulrahman GO Jr. The effect of multidisciplinary team care on cancer management. Pan Afr Med J. 2011;9:20. 5. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.1.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed January 29, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.