علاج ابيضاض الدم النخاعي الحاد الأولي المقاوم أو المنتكس في المرضى المناسبين للعلاج الكيميائي المكثف وزراعة الخلايا المكونة للدم الخيفية

References

1. For fit patients with relapsed AML, the recommended treatment is salvage ChT followed by alloHCT [III, B]
2. The outcome of patients with primary refractory AML is dismal, with no realistic prospect of long-term survival after salvage ChT; thus, alloHCT is the most effective treatment option providing long-term survival in 20%–30% of patients [III, B]
3. The authors recommend a salvage protocol based on high- or intermediate-dose cytarabine in combination with an anthracycline and, optionally, a purine analogue (e.g. FLAG-Ida) [II, B].
4. Outcomes for patients with primary refractory AML may be better with a sequential transplant conditioning regimen, in which a combination of cytarabine/amsacrine ChT is followed by a fludarabine-based RIC regimen (FLAMSA-RIC) [III, C].
5. Patients with late relapse (≥12 months after the end of first-line treatment) may also benefit from retreatment with the previously successful induction regimen.
6. AlloHCT should be considered for all fit, eligible patients who entered second CR [III, B], as it represents the only chance for long-term survival.