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A 32 -year-old female patien t presen ts with fatigue and dyspnea. She appears pale, but has an otherwise normal physical examination. Complete blood cou nt shows leukocyte count 1 95 .000/,LLL. hemoglobin 6.8 g/dl, and platelet count 1 0.000/,LLL. The periph- eral blood smear is shown below.
What is the standard approach for treatment in favorable-risk acute myeloid leukemia in a young, healthy patient?
- Immediate referral for bone marrow transplantation
- Observation in the case of extramedullary-only disease until symptoms occur
- Standard induction therapy with cytarabine and an anthracycline
- Single-agent azacitidine
Medicine
C. Favorable risk AML is treated with cytarabine and an anthracycline (7 + 3). Bone marrow transplantation is used in relapsed or refractory AML, in patients obtaining second remission, or in some patients with intermediate-risk AML in first remission. Extramedullary AML should be treated rather than observed. Azacitidine is sometimes used as a single agent in the treatment of elderly n patients with AML.
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