The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information

Added text to clarify the history of myelodysplastic syndromes or another antecedent hematological disorder as among the adverse prognostic factors.

Added text to include fluorescence in situ hybridization as a means of detecting fusion genes formed in t(8; 21) and inv(16).

Classification

Added text to include patient preference as a factor on which to base decision to treat.

Added text to state that AML with an FLT3 mutation is not in the WHO classification scheme.

Added text to state that those with 11q23 abnormalities are exceptions in the acute myeloid leukemia with characteristic genetic abnormalities category; also added fluorescence in situ hybridization as a means for detecting translocations.

Treatment Option Overview

Added Godwin et al. as reference 12.

Added text about the insignificant impact of growth factors on survival in most randomized clinical trials and the less than routine recommendation for their use in the remission induction setting.

Untreated Adult Acute Myeloid Leukemia

Added text about older adults who either decline or are unfit for intensive remission induction therapy but who may benefit from low-dose cytarabine; the complete remission rate for the recommended regimen of cytarbine was significantly higher than the remission rate for patients treated with hydroxyurea as was overall survival (cited Burnett et al. as reference 13 and level of evidence 1iiA).

Added bullet to include cytarabine plus mitoxantrone to the list of combination chemotherapy regimens used for remission induction therapy (cited Löwenberg et al. as reference 42).

Adult Acute Myeloid Leukemia in Remission

Added Cheson et al. as reference 1.

Added text about the lack of improvement in overall survival when compared to chemotherapy-based postremission regimens even though allogeneic bone marrow transplantation has the lowest incidence of leukemic relapse.

Recurrent Adult Acute Myeloid Leukemia

Added text about the similarity found in patients who relapse following an allogeneic transplant and undergo a donor lymphocyte infusion (DLI) and patients with relapsing chronic myelogenous leukemia; no published studies of prospective trials examining the role of DLI for patients with acute myeloid leukemia exist. A retrospective European study found a greater number of patients who relapsed after an allogeneic transplant received DLI as part of their salvage therapy and showed significant advantage in overall survival, although the survival advantage might result from selection bias; the remission rate was considerably less than the rate reported for chronic myelogenous leukemia (cited Schmid et al. as reference 22, Dazzi et al. as reference 23, and level of evidence 3iiiA).

Added text about the incorporation of arsenic trioxide into the postremission treatment strategy of de novo acute promyelocytic leukemia patients in clinical trials.

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