Therapy of Newly Diagnosed Acute Myeloid Leukemia (AML)

Abstract

From the 1970s when “7+3” was first employed until only recently, the topic of “Therapy of Newly Diagnosed AML” would have been relatively limited. However, four features have changed this therapeutic landscape. One, there has been experimentation with increased regimen intensity along with approval of five new agents for newly diagnosed disease (and three others approved in the relapse setting). Second, we have made substantial gains in our understanding of both pretreatment disease and patient characteristics that can help guide regimen selection. Third, improvements in supportive care have not only allowed patients to live longer with their disease but also allowed for increasing of treatment intensity upfront, especially for patients who historically have not been considered candidates for such therapy. And finally, there is broader access to allogeneic hematopoietic cell transplantation (the role of allogeneic transplant as part of this approach will be discussed in Chap. 7). Within this new therapeutic landscape, we can now risk stratify patients a priori and offer different treatment regimens tailored to an individual situation. This chapter will outline a contemporary approach to balancing disease features and risk with patient comorbidities in choosing initial AML therapy.