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Post-remission therapy for acute myeloid leukemia in younger adults

Author
Richard A Larson, MD
Section Editor
Bob Lowenberg, MD, PhD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

Sixty to 80 percent of adult patients with newly diagnosed acute myeloid leukemia (AML) will attain a complete remission (CR) with intensive induction chemotherapy. However, without additional cytotoxic therapy, virtually all of these patients will relapse within a median of four to eight months [1]. In contrast, patients who receive post-remission therapy may expect four-year survival rates as high as 40 percent in young and middle-aged adults.

Post-remission therapy aims to destroy leukemia cells that survived induction chemotherapy but are undetectable by conventional studies. There are three basic options for post-remission therapy (in order of increasing intensity): consolidation chemotherapy, autologous hematopoietic cell transplantation (HCT), or allogeneic HCT. The choice among these approaches for an individual patient depends upon a number of factors including:

Expected rate of relapse with consolidation chemotherapy alone (influenced strongly by the tumor karyotype)

Expected morbidity and mortality associated with treatment options (as determined by patient characteristics such as age and comorbidities)

Salvage treatments available for the treatment of relapsed disease

                       

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Literature review current through: Nov 2016. | This topic last updated: Thu Sep 08 00:00:00 GMT+00:00 2016.
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