Management of older patients with Acute Myeloid Leukaemia
The American Society of Haematology has published a guideline on the treatment of AML in older patients.
If intensive treatment is to be recommended for an older patient then consider the following:
In patients over 60:
- Good risk patients should be given an intensive schedule: AML 12 or AML 14 as indicated below.
- Poor risk patients as defined by AML 19 criteria should not be offered intensive treatment but can be offered LI-1 trial.
- The treatment of standard risk patients should be individualised. Intensive treatment should not be decided solely by some arbitrary age limit as good risk patients in AML 11 did significantly better than poor risk patients in AML 10.
For older patients with AML that are suitable for intensive treatment, give 3 courses of chemotherapy.
DA 3+10 followed by DA 3+8 plus MidAC
- Course 1 DAT 3 + 10:
- Daunorubicin 35 mg/m2 IV bolus daily, days 1, 2 and 3.
- Cytarabine 100 mg/m2 ,IV bolus, BD days 1-10.
- Course 2 DAT 3 + 8:
- Daunorubicin 35 mg/m2 IV bolus, daily, days 1, 2 and 3.
- Cytarabine 100 mg/m2 IV bolus, BD days 1-8.
- Course 3 MidAC:
- Mitoxantrone 8 mg/m2 IV bolus, daily, days 1,2 and 3.
- Cytarabine 500 mg/m2 IV infusion, BD days 1, 2 and 3.
Topic Code: 4664
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