Patients are stratified according to risk category by multiple factors in order to determine ability to receive intensive induction therapy.19
The standard therapy for AML patients eligible for intensive induction therapy has not changed significantly in the past 40 years.6,8
- Induction therapy with 7+3 combination chemotherapy (7 days of cytarabine and 3 days of an anthracycline)
- Followed by consolidation therapy to maintain remission (high-dose chemotherapy)
- Some eligible patients with intermediate/poor risk disease may also receive a stem cell transplant along with consolidation therapy
Outcomes remain poor, with high rates of relapse for most patients. Older patients pose a difficult therapeutic challenge due to comorbidities and poor performance status, which may make them ineligible for intensive therapy.14 Survival in older patients who are unable to receive intensive treatment is 5-10 months.22
An increased understanding of the pathophysiology of AML has facilitated the development of novel, molecularly targeted therapies. However, these recent additions may only benefit certain patients due to the heterogeneity of the disease.