What are the National Comprehensive Cancer Network (NCCN) guidelines for supportive care in the treatment of acute myeloid leukemia (AML)?

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

The NCCN guidelines recommend that all patients receive supportive care that includes the following [25] :

  • Use of leukodepleted, irradiated blood products

  • Tumor lysis prophylaxis — Not all AML patients are at high risk for tumor lysis syndrome (TLS). Independent risk factors for TLS are pretreatment serum lactate dehydrogenase (LDH) levels above laboratory normal values, creatinine > 1.4 mg/dL, uric acid > 7.5 mg/dL and white blood cell (WBC) counts > 25 x 109/L.

  • Growth factors for post-remission therapy may be considered but may impact interpretation of the bone marrow evaluation

  • Use and choice of antibiotics for prophylaxis should be based on the prevailing organisms and their drug resistance patterns

  • Patients receiving high-dose cytarabine require neurologic assessment before each dose. Cytarabine should be stopped in those who develop cerebellar toxicity.  


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