Acute Myeloid Leukemia (AML) Questions & Answers

Updated: Jun 25, 2019
  • Author: Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD  more...
  • Print
Questions & Answers

Overview

What is acute myeloid leukemia (AML)?

What is the underlying pathophysiology of acute myeloid leukemia (AML)?

What are the clinical manifestations of acute myeloid leukemia (AML)?

What is the effectiveness of standard chemotherapy regimens for the treatment of acute myeloid leukemia (AML)?

What is the pathophysiology of acute myeloid leukemia (AML)?

What are the risk factors for acute myeloid leukemia (AML)?

What is the most common risk factor for acute myeloid leukemia (AML)?

Which congenital disorders increase the risk for acute myeloid leukemia (AML)?

What is the role of genetics in the etiology of acute myeloid leukemia (AML)?

How are germline mutations that predispose to acute myeloid leukemia (AML) classified?

What is the role of Li-Fraumeni syndrome in the etiology of acute myeloid leukemia (AML)?

What is the role of radiation exposure in the etiology of acute myeloid leukemia (AML)?

What is the role of smoking in the etiology of acute myeloid leukemia (AML)?

Which environmental exposures increase the risk of acute myeloid leukemia (AML)?

What is the role of chemotherapeutic agents in the etiology of acute myeloid leukemia (AML)?

How does acute myeloid leukemia (AML) develop in patients exposed to chemotherapy agents?

What is the incidence of acute myeloid leukemia (AML) in the US?

What age group is at highest risk for acute myeloid leukemia (AML)?

How does the incidence of acute myeloid leukemia (AML) vary by sex?

How many deaths are attributed to myeloid leukemia (AML) annually in the US?

Which factors affect the prognosis of acute myeloid leukemia (AML)?

Which cytogenetic findings prognostic for acute myeloid leukemia (AML)?

Which genetic mutations have an adverse effect on the prognosis of acute myeloid leukemia (AML)?

How do survival rates for acute myeloid leukemia (AML) vary by age?

What is the prognosis of therapy-related acute myeloid leukemia (AML)?

What is the prognosis of acute myeloid leukemia (AML) in smokers?

What causes death in acute myeloid leukemia (AML)?

What is included in the patient education information for acute myeloid leukemia (AML)?

Presentation

What history suggests acute myeloid leukemia (AML)?

What are the signs and symptoms of acute myeloid leukemia (AML)?

What are the symptoms of organ infiltration with leukemic cells in acute myeloid leukemia (AML)?

Which physical findings suggest acute myeloid leukemia (AML)?

What are the symptoms of thrombocytopenia in acute myeloid leukemia (AML)?

What does a finding of hepatosplenomegaly indicate in the evaluation of acute myeloid leukemia (AML)?

What are the signs 0f leukostasis in acute myeloid leukemia (AML)?

DDX

What is the most important medicolegal pitfall in the diagnosis of acute myeloid leukemia (AML)?

Which disorders should be included in the differential diagnoses for acute myeloid leukemia (AML)?

What are the differential diagnoses for Acute Myeloid Leukemia (AML)?

Workup

Which tests are performed in the workup of acute myeloid leukemia (AML)?

What is the role of immunophenotyping in the diagnosis of acute myeloid leukemia (AML)?

When is human leukocyte antigen (HLA) or deoxyribonucleic acid (DNA) typing indicated in the evaluation of acute myeloid leukemia (AML)?

Which diagnostic studies are included in the workup of acute myeloid leukemia (AML) with possible CNS involvement?

What is the role of chest radiography in the diagnosis of acute myeloid leukemia (AML)?

Why is evaluation of myocardial function needed following a confirmed diagnosis of acute myeloid leukemia (AML)?

What is the role of a complete blood count (CBC) in the diagnosis of acute myeloid leukemia (AML)?

What is the role of coagulation studies in the evaluation of acute myeloid leukemia (AML)?

What is the role of peripheral blood smear in the diagnosis of acute myeloid leukemia (AML)?

What is the role of the blood chemistry profile in the evaluation of acute myeloid leukemia (AML)?

When are blood cultures indicated in the diagnosis of acute myeloid leukemia (AML)?

What is the role of flow cytometry (immunophenotyping) in the evaluation of acute myeloid leukemia (AML)?

What is the role of cytogenetic studies in the management of acute myeloid leukemia (AML)?

Which genetic abnormalities convey a more favorable prognosis of acute myeloid leukemia (AML)?

Which genetic abnormalities convey intermediate risk for acute myeloid leukemia (AML)?

Which genetic abnormalities are indicators of a poor prognosis for acute myeloid leukemia (AML)?

How are cytogenetic studies used to diagnose acute promyelocytic leukemia (APL)?

What is the role of fluorescence in situ hybridization (FISH) studies in the evaluation of acute myeloid leukemia (AML)?

What is the prognosis of acute myeloid leukemia (AML) in patients with a monosomal karyotype?

What is the role of a bone marrow evaluation in the diagnosis of acute myeloid leukemia (AML)?

What is the most commonly mutated gene in acute myeloid leukemia (AML)?

What are the clinical implications of NPM1 mutations in patients with acute myeloid leukemia (AML)?

What is the prevalence of mutations in CEBPA in acute myeloid leukemia (AML)?

What is the clinical implication of high BAALC expression in acute myeloid leukemia (AML)?

What is the clinical implication of MLL partial tandem duplication (MLL-PTD) in acute myeloid leukemia (AML)?

What is the clinical implication of DNMT3A mutations in acute myeloid leukemia (AML)?

How is the clinical implication of high expression of miR-181a in acute myeloid leukemia (AML)?

What is the role of gene expression profiling in the management of acute myeloid leukemia (AML)?

What is the role of chest radiography in the diagnosis of acute myeloid leukemia (AML)?

What is the role of multiple gated acquisition (MUGA) scanning in the evaluation of acute myeloid leukemia (AML)?

What is the role of electrocardiography in the evaluation of acute myeloid leukemia (AML)?

What is the traditional French-American-British (FAB) classification of acute myeloid leukemia (AML)?

What is the WHO classification of acute myeloid leukemia (AML)?

Treatment

What are the treatment options for acute myeloid leukemia (AML)?

What should be avoided by patients receiving standard chemotherapy regimens for the treatment of acute myeloid leukemia (AML)?

What is included in transfusion support for patients with acute myeloid leukemia (AML)?

Where should patients with acute myeloid leukemia (AML) receive treatment?

What are the most common medication regimens for the treatment of acute myeloid leukemia (AML)?

What is the efficacy of daunorubicin induction regimens for the treatment of acute myeloid leukemia (AML)?

What is the efficacy of cytarabine combination induction regimens for the treatment of acute myeloid leukemia (AML)?

What is the role of midostaurin in the treatment of acute myeloid leukemia (AML)?

What is the role of cladribine in the treatment of acute myeloid leukemia (AML)?

What is the role of allogeneic stem cell transplantation (SCT) in the treatment of acute myeloid leukemia (AML)?

What are the dosage options for cytarabine in the treatment of acute myeloid leukemia (AML)?

What are the 4-year remission rates for acute myeloid leukemia (AML) treated with cytarabine?

What is the prognosis of good-risk acute myeloid leukemia (AML)?

What are the survival rates following consolidation therapy for acute myeloid leukemia (AML)?

What is the role of autologous stem cell transplantation (ASCT) in the treatment of acute myeloid leukemia (AML)?

In which patients with acute myeloid leukemia (AML) does hematopoietic stem cell transplantation (HSCT) offer a survival advantage?

What are the NCCN guidelines for hematopoietic stem cell transplantation (HSCT) in the treatment of acute myeloid leukemia (AML)?

What is required prior to the referral for allogeneic transplantation for acute myeloid leukemia (AML)?

What is the role of gemtuzumab ozogamicin (Mylotarg) in the treatment of acute myeloid leukemia (AML)?

What is the efficacy of gemtuzumab ozogamicin (Mylotarg) in the treatment of acute myeloid leukemia (AML)?

What are the treatment options for older patients with acute myeloid leukemia (AML)?

What is the prognosis of acute myeloid leukemia (AML) in older patients?

Which therapies are most commonly used to treat acute myeloid leukemia (AML) in elderly patients?

What is the efficacy of azacitidine for the treatment of acute myeloid leukemia (AML) in older patients?

What is the efficacy of decitabine for the treatment of acute myeloid leukemia (AML) in elderly patients?

What is the efficacy of standard therapy for the treatment of acute myeloid leukemia (AML) in older patients?

What is the efficacy of high-dose daunorubicin for the treatment of acute myeloid leukemia (AML) in elderly patients?

What is the role of combination liposomal cytarabine and daunorubicin (Vyxeos) in the treatment of acute myeloid leukemia (AML)?

What are the treatment options for older patients who are not candidates for intensive chemotherapy for the treatment of acute myeloid leukemia (AML)?

What is the role of clofarabine in the treatment of acute myeloid leukemia (AML)?

What is the standard consolidation therapy for the treatment of acute myeloid leukemia (AML) in older adults?

Which factor increases the risk of death from allogeneic hematopoietic stem cell transplantation (HSCT) for acute myeloid leukemia (AML)?

How is therapy-related acute myeloid leukemia (AML) treated?

What is acute promyelocytic leukemia (APL)?

What are the histologic subtypes of acute promyelocytic leukemia (APL)?

How is acute promyelocytic leukemia (APL) diagnosed?

Which cytogenetic abnormalities may be present in acute promyelocytic leukemia (APL)?

What is the efficacy of all-trans-retinoic acid (ATRA) in the treatment of acute promyelocytic leukemia (APL)?

What is retinoic acid syndrome in acute promyelocytic leukemia (APL)?

What are the treatment options for acute promyelocytic leukemia (APL)?

What are treatment options for acute promyelocytic leukemia (APL) in patients younger than 60 years?

How is acute promyelocytic leukemia (APL) treated in patients older than 60 years?

What are the remission rates of acute promyelocytic leukemia (APL) following treatment with or without cytarabine?

What is the treatment response rate in patients with acute promyelocytic leukemia (APL) who are younger than 60 years?

What is the role of arsenic trioxide in the treatment of acute promyelocytic leukemia (APL)?

What is the efficacy of arsenic trioxide with all-trans-retinoic acid (ATRA) for the treatment of acute promyelocytic leukemia (APL)?

What are the NCCN treatment guidelines for acute promyelocytic leukemia (APL)?

What is the prognosis of relapsed acute myeloid leukemia (AML)?

What are the likelihood of achieving a second remission following relapse of acute myeloid leukemia (AML)?

What are the adverse prognostic factors for relapsed acute myeloid leukemia (AML)?

What are the standard regimens for treatment of relapsed acute myeloid leukemia (AML)?

What is the role of the CLAG-M regimen in the treatment of relapsed acute myeloid leukemia (AML)?

What is the role of the MEC regimen for the treatment of relapsed acute myeloid leukemia (AML)?

What is the role of enasidenib in the treatment of relapsed acute myeloid leukemia (AML)?

What is the role of gemtuzumab ozogamicin (Mylotarg) in the treatment of relapsed acute myeloid leukemia (AML)?

Why is replacement of blood products necessary in the management of acute myeloid leukemia (AML)?

When are packed red blood cells (RBCs) indicated in the treatment of acute myeloid leukemia (AML)?

When is platelet transfusion indicated in the treatment of acute myeloid leukemia (AML)?

What is the role of fresh frozen plasma (FFP) in the treatment of acute myeloid leukemia (AML)?

What is the role of IV antibiotics in the treatment of acute myeloid leukemia (AML)?

How is persistent fever managed in acute myeloid leukemia (AML)?

What are the guidelines for antibiotic prophylaxis in the management of acute myeloid leukemia (AML)?

What is the role of posaconazole in the treatment of acute myeloid leukemia (AML)?

When are IV antibiotics indicated in the treatment of acute myeloid leukemia (AML)?

How is hyperuricemia treated in patients with acute myeloid leukemia (AML)?

What is the effect of granulocyte colony-stimulating factor (G-CSF) on induction therapy for acute myeloid leukemia (AML)?

What is the effect of granulocyte macrophage colony-stimulating factor (GM-CSF) on induction therapy for the treatment of acute myeloid leukemia (AML)?

What is the role of venous catheter placement in the treatment of acute myeloid leukemia (AML)?

What are the dietary restrictions for patients with acute myeloid leukemia (AML)?

What are the activity restrictions for patients with acute myeloid leukemia (AML)?

What is included in the long-term monitoring of acute myeloid leukemia (AML)?

Guidelines

Who has issued guidelines on the initial diagnostic workup of acute myeloid leukemia (AML)?

Which organizations have issued treatment guidelines for acute myeloid leukemia (AML)?

What are the College of American Pathologists and the American Society of Hematology (CAP/ASH) guidelines for the diagnostic workup of acute myeloid leukemia (AML)?

What are the National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines for the diagnostic workup for acute myeloid leukemia (AML)?

What are the European Society of Medical Oncology (ESMO) guidelines testing in the diagnostic workup for acute myeloid leukemia (AML)?

When is sperm preservation and pregnancy testing indicated in the workup of acute myeloid leukemia (AML)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for neurological testing in the evaluation of acute myeloid leukemia (AML)?

What are the guidelines for assessment of cardiac risk factors in acute myeloid leukemia (AML)?

How is the risk pattern in acute myeloid leukemia (AML) determined?

How does the European Society of Medical Oncology (ESMO) risk classification for acute myeloid leukemia (AML) vary from that of the National Comprehensive Cancer Network (NCCN)?

Which chromosomal translocations are diagnostic of acute promyelocytic leukemia (APL)?

What are the treatment guidelines for acute myeloid leukemia (AML)?

How do the treatment guidelines for acute myeloid leukemia (AML) of the National Comprehensive Cancer Network (NCCN) differ from those of the European Society of Medical Oncology (ESMO)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for supportive care in the treatment of acute myeloid leukemia (AML)?

What are the National Comprehensive Cancer Network (NCCN) guidelines for supportive care in the treatment of acute promyelocytic leukemia (APL)?

What does the National Comprehensive Cancer Network (NCCN) recommend against in the treatment of acute promyelocytic leukemia (APL)?

Medications

What are restrictions on medications used in the treatment of acute myeloid leukemia (AML)?

Which medications in the drug class Antineoplastics, Tyrosine Kinase Inhibitor are used in the treatment of Acute Myeloid Leukemia (AML)?

Which medications in the drug class Antineoplastics are used in the treatment of Acute Myeloid Leukemia (AML)?

Which medications in the drug class Bcl-2 Inhibitor are used in the treatment of Acute Myeloid Leukemia (AML)?

Which medications in the drug class Antineoplastics, Hedgehog Pathway Inhibitor are used in the treatment of Acute Myeloid Leukemia (AML)?

Which medications in the drug class IDH Inhibitors are used in the treatment of Acute Myeloid Leukemia (AML)?