NCCN and ESMO guidelines For the diagnosis and management of AML

Abstract

Both the NCCN and ESMO guidelines recommend including the following tests in the diagnostic work-up for AML:  Complete blood count (CBC) with manual differential and routine chemistry profile (including liver function tests, serum creatinine, lactate dehydrogenase [LDH], and uric acid).  Coagulation profile-Prothrombin time (PT), partial thromboplastin time (PTT), fibrinogen).  Bone marrow aspiration and biopsy, including classical cytogenetics, Immunophenotyping, and molecular testing for c-KIT, FLT3-ITD, NPM1, and CEBPA.  HLA typing of patient and family.  Assessment of cardiac risk factors (by echocardiogram or multi-gated acquisition [MUGA] scan). ESMO guidelines include the following additional tests to the diagnostic workup for all patients :  Imaging studies, including dental survey and computed tomography (CT) scan of the chest and abdomen, or chest x-ray and abdominal ultrasound.  Sperm preservation in men (if desired by patient).  Pregnancy test in women.

Venetoclax + hypomethylating agents combined with dose-adjusted HAG for relapsed/refractory acute myeloid leukemia

“…According to guidelines approved by NCCN, AML is characterized by the presence of more than 5% leukemia cells in peripheral blood or bone marrow after complete remission. [ 8 ] The majority of scholars consider a patient to have R/RAML if a complete remission does not occur after 2 courses of induction chemotherapy, and when this occurs, the treatment plan needs to be adjusted. [ 9 – 11 ] Because of the high failure rate of reinduction treatment after relapse of AML, R/RAML is common in the clinic.…”