Acute Myeloid Leukaemia

Alan K. Burnett*, David Grimwade

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

2 Citations (Scopus)

Abstract

Acute myeloid leukaemia, primarily a disease of the elderly, characterised by the consequences of marrow failure occuring in 15 per 100,000 of the population and 2-3 per 100,00 in children. There is considerable heterogeneity of morphology, immunophentype, cytogenetic and molecular abnormalities which in several cases provide useful prognostic information, and future development of targeted treatment. Chemotherapy remains the backbone of treatment, combining and anthracycline with a nucleoside analogue, cytosine arabinoside, for remission induction which is succssful in 75-80% in younger patients, and 55-60% in older patients. Consolidation comprises further courses, usually of high dose Ara-C, or, in selected higher risk cases, stem cell transplant which cures 45-50% of younger but only 15% of older patients reflecting the differing biology in the older patients. A substantial proportion of elderly patients are unlikely to benefit from conventional chemotherapy will receive supportive care only, or with low dose Ara-C or demethylation agents, but both are less than satisfactory treatments. There is an emerging theme to "personalise" treatment based on disease biology and use individual risk assessment with minimal residual disease monitoring. Both strategies have been effectively deployed in the acute promyelocytic leukaemia subgroup, and may represent a template for other subgroups.

Original languageEnglish
Title of host publicationPostgraduate Haematology: Seventh Edition
PublisherWILEY-BLACKWELL
Pages352-370
Number of pages19
ISBN (Print)9781118853771, 9781118854327
DOIs
Publication statusPublished - 6 Nov 2015

Keywords

  • Chemotherapy
  • Cytogenetics
  • Leukaemia
  • Mutations
  • Myeloid

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