First-Line Treatment of AML with ELN Favourable or Intermediate Risk

Clinical Scenario

This protocol covers patients with acute myeloid leukaemia classified as ELN favourable or intermediate risk who do not meet any of the following exclusion criteria:

Not core binding factor AML Not therapy-related AML Not AML with myelodysplasia-related changes Not FLT3-ITD/TKD positive Not ELN adverse risk

Treatment Approach

Combination induction chemotherapy is the recommended approach for this patient population. The specific regimen and any additional agents considered depend on patient and disease characteristics — the complete algorithm is in the full protocol.

Full regimen details, sequencing, and consolidation guidance are available in the structured protocol below.

Treatment Goals

The primary aim of induction is complete remission or complete remission with incomplete count recovery (CR/CRi), defined as fewer than 5% blasts in the bone marrow. Response is assessed between day 14 and day 21 after the first induction cycle.

Instant Access to Structured Evidence-Based Regimens

References

If none of the previous markers is positive, 7+3 induction chemotherapy is generally recommended [II, A].

The addition of GO to 7+3 may also be considered in younger CD33-positive patients with non-CBF-AML with ELN favourable or intermediate risk [II, C].

After the first induction cycle, response should be assessed between day 14 and day 21.

As soon as patients achieve CR/CRi after 1 or 2 induction cycles, they should proceed to consolidation treatment [II, B].

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