علاج سرطان الدم الحاد النقوي المشخص حديثاً في المرضى الذين تبلغ أعمارهم ≥75 عاماً أو غير المؤهلين للتحريض المكثف

References

1. Pre-existing heart, kidney, lung or liver disease, mental illness, an Eastern Cooperative Oncology Group (ECOG) performance score 3 and age 75 years are the strongest predictors for nonrelapse induction-related mortality and should be considered to determine ineligibility to intensive induction and consolidation ChT [V, B].
2. The HMAs azacitidine and decitabine are currently the first choice in newly diagnosed unfit AML patients [II, B].
3. Thus, if decitabine is chosen, it is recommended to follow the 5-day schedule [II, B].
4. Given the moderate effects of HMAs, LDAC remains an alternative to HMAs in the first-line treatment of AML patients who are ineligible for standard induction and consolidation ChT, except in patients with adverse-risk cytogenetics, where LDAC has very poor activity [II, B].
5. In patients treated nonintensively, response should be assessed at the very least after 4 cycles to diagnose refractory disease, and every 3 months thereafter if patients have no or incomplete recovery of at least one of the three blood lineages to identify refractory disease.
6. HMA treatment is usually continued until disease progression or intolerance but may be terminated after at least 4 consecutive cycles if the patient has not responded or derived clinical benefit.