Risk Stratification and Management of Acute Myeloid Leukemia
Jean A. Ridgeway, MSN, APN, NP-C, AOCN®
From the University of Chicago Medical Center, Chicago, Illinois
Jean A. Ridgeway, MSN, APN, NP-C, AOCN®, reported a financial interest/relationship in the form of: Speaker’s Bureau: Celgene, MGI Pharma (Eisai).
Correspondence to: Jean A. Ridgeway, MSN, APN, NP-C, AOCN®, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 2115, Chicago, IL 60637-1470. E-mail: firstname.lastname@example.org
J Adv Pract Oncol 2011;2(Suppl 2):19–26 |
© 2011 Harborside Press®
Acute myeloid leukemia (AML), a heterogeneous group of distinct clonal malignancies, accounts for 80% of acute leukemias in adults. The incidence of AML among US adults is increasing, particularly in those older than 60. Risk factors for AML include inherited genetic predisposition syndromes, congenital factors, and antecedent hematologic disorders. Acute myeloid leukemia is classified according to morphology, immunohistochemistry, cell surface markers, and cytogenetic and molecular abnormalities. The most important prognostic factors are cytogenetic/molecular characteristics of the AML, patient age, and patient performance status. Treatment depends on disease characteristics, patient comorbidities, and age. The goal of induction chemotherapy is to achieve a complete response; postinduction therapy is given to reduce the risk of relapse. Autologous or allogeneic hematopoietic cell transplantation for remission consolidation is an option for some patients. Prognosis is poor for patients more than 60 years of age, and newer approaches, such as the use of hypomethylating agents, are being investigated to improve outcomes in this age group. New therapies, including arsenic trioxide, are also being studied for acute promyelocytic leukemia, a subtype of AML. Supportive therapy, including blood products and antimicrobial, antiviral, and antifungal agents, is a main component of AML treatment.
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