What are the standard regimens for treatment of relapsed acute myeloid leukemia (AML)?

Updated: May 26, 2020
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Owing to the poor outcome with salvage therapy, it is important to refer patients for well-designed clinical trials whenever possible. For patients who are unable to participate in a clinical trial, but are able to tolerate aggressive therapy, options include the following [25] :

  • Cladribine + cytarabine + granulocyte colony-stimulating factor (G-CSF), with or without mitoxantrone or idarubicin [48]
  • High-dose cytarabine (if not received previously in treatment) with or without idarubicin, daunorubicin, or mitoxantrone
  • Fludarabine + cytarabine + G-CSF with or without idarubicin
  • Etoposide + cytarabine with or without mitoxantrone [99]
  • Clofarabine with or without cytarabine + G-CSF, with or without idarubicin

For patients who require less aggressive therapy, possible regimens include the following [25] :

  • Hypomethylating agents (azacitidine or decitabine)
  • Venetoclax with hypomethylating agents or low-dose cytarabine 
  • Low-dose cytarabine

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