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  Česky / Czech version Trans. Hemat. dnes, 9, 2003, No. 3, p. 110–124.
 
Current treatment options of acute myelogenous leukemia in younger patients 
Mayer J., Doubek M. 

Interní hematoonkologická klinika LF MU a FN, Brno
 


Summary:

       The primary objective in treating patients with acute myelogenous leukemia (AML) is to induce remission and thereafter prevent relapse. Despite the fact that 60–80% of patients with AML achieve complete remission after induction therapy most of them relapse and die of the disease.Once remission has been achieved, further intensive therapy is needed to prevent relapse. Younger patients have three main options after going into remission: intensive postremission chemotherapy (chemotherapeutic courses of various intensity have been evaluated without clear conclusion), autologous stem cell transplantation, or allogeneic stem cell transplantation. Allogeneic stem cell transplantation can cure the most of patients. Patients with standard-risk disease have traditionally been referred for matched sibling allograft if donor is available. Patients with high-risk disease have been referred for matched sibling or matched unrelated donor allograft. Transplantation is possibly unnecessary in low-risk patients in first remission. Unfortunately, even today the high mortality of allograft is a problem. The role of nonmyeloablative transplantations and peripheral blood stem cells (PBSC) transplantation remains unclear.The main reason for the increasing use of PBSC relies on rapid hematopoietic recovery observed with PBSC compared with bone marrow. However, PBSC transplantation might be associated with increased incidence and severity of acute graft-versus-host disease. There is a lot of obscurities in treatment of AML. While, during the last decades, the evolution of AML therapy was characterized by attempts to intensify all phases of treatment, increasing insights into the biology of this disease (cytogenetic features, molecular genetic features) now promise to lead to risk-adapted and more effective therapeutic approaches.

        Key words: acute myelogenous leukemia, prognostic factors, treatment
       

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