What are the ASH guidelines on the treatment of newly diagnosed acute myeloid leukemia (AML) in older adults?

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

ASH guidelines for treatment of newly diagnosed AML in older adults include the following recommendations and suggestions [113] :

  • ASH recommends offering antileukemia therapy over best supportive care, and suggests intensive antileukemic therapy over less-intensive antileukemic therapy, for patients who are candidates for such therapy. 
  • For patients who achieve remission after ≥1 cycle of intensive antileukemic therapy and who are not candidates for allogeneic transplantation, ASH suggests postremission therapy over no additional therapy. 
  • For patients considered appropriate for antileukemia therapy but not intensive antileukemic therapy, ASH suggests using monotherapy with either a hypomethylating agent or low-dose-cytarabine, rather than combining either of those drugs with other agents; however, ASH notes that this guidance may change with upcoming reporting of randomized trials showing a benefit of combination therapies over monotherapy.
  • For patients who achieve a response after receiving less-intensive therapy, ASH suggests continuing therapy indefinitely until progression or unacceptable toxicity over stopping therapy.
  • For patients who are no longer receiving antileukemic therapy, ASH suggests having red blood cell transfusions available over not having transfusions available.

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