Treatment Goals in Acute Myeloid Leukemia (AML)


Generally, AML treatment is divided into 2 phases: remission induction therapy and post-remission therapy. The approach varies by age and other factors.1,2

Patients <60 years1 Patients ≥60 years1
  • Customarily receive intensive therapy
  • Treatment regimen includes induction therapy and post-remission therapy (consolidation)
  • Patients are evaluated for stem cell transplantation in first remission depending on risk status
  • Candidate for intensive induction therapy is dependent on factors including age, performance status (PS), and comorbidities
  • Consider low-intensity therapy

 

Treatment for AML can be characterized by 6 features3:

  • Defined by cytogenetic and molecular interactions
  • Intensified induction/less intensive consolidation therapy
  • Increased significance of minimal residual disease (MRD)
  • Expanded availability of allogeneic hematopoietic-cell transplantation (allo-HCT)
  • Paradigm shift in older patients
  • Incorporation of newer agents

The goals of treatment for patients diagnosed with AML are:

  • Cure
    • The goal of induction therapy is remission. Patients who are in remission should be treated with post-remission therapy4
    • AML has a greater chance of being cured in younger patients than in older patients5
  • Palliation6
    • Palliation can improve quality of life and decrease disease symptoms for patients with AML
    • Recently, palliative care has been used in conjunction with curative care to increase comfort and help improve the quality of life for patients whose therapy goal is to cure their AML

References: 1. 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. 2. Talati C, Sweet K. Recently approved therapies in acute myeloid leukemia: a complex treatment landscape. Leuk Res. 2018;73:58-66. 3. Tallman M. Prognostic significance of molecular markers and targeted regimens in the management of acute myeloid leukemia. J Natl Compr Canc Netw. 2018;16(5.S):656-659. 4. Döhner H, Weisdorf DJ, Bloomfield CD. Acute myeloid leukemia. N Engl J Med. 2015;373(12):1136-1152. 5. Eleni LD, Nicholas ZC, Alexandros S. Challenges in treating older patients with acute myeloid leukemia. J Oncol. 2010;2010:943823. 6. Meier DE, Brawley OW. Palliative care and the quality of life. J Clin Oncol. 2011;29(20):2750-2752.