Flow Chart for the Therapy of Newly Diagnosed Acute Myeloid Leukemia (AML)
Flow chart for the therapy of newly diagnosed acute myeloid leukemia (AML). For all forms of AML except acute promyelocytic leukemia (APL), standard therapy includes a regimen based on a 7-day continuous infusion of cytarabine (100-200 mg/m2 per day) and a 3-day course of daunorubicin (60-90 mg/m2 per day) with or without additional drugs. Idarubicin (12-13 mg/m2 per day) could be used in place of daunorubicin (not shown). Patients who achieve complete remission (CR) undergo postremission consolidation therapy, including sequential courses of high-dose cytarabine, autologous hematopoietic stem cell transplantation (HSCT), allogeneic HSCT, or novel therapies, based on their predicted risk of relapse (i.e., risk-stratified therapy). Patients with APL (see text for treatment) usually receive tretinoin and arsenic trioxide-based regimens with or without anthracycline-based chemotherapy and possibly maintenance with tretinoin. CBF, core binding factor; ITD, internal tandem duplication.