Saturday, December 25, 2021

NCCN updates 2021 Heme malignancies

 AML

Newly diagnosed AML

a. If CBF positive--> add GO to 7+3

b. FLT 3 mutation positive--> add midostaurin to 7+3 ( age 18-60 yr per study, not per FDA label)

c. Secondary AML or t-AML--> use CPX351( liposomal cytarabine with daunorubicin 5:1 ratio) CPX-351 had a higher median OS than 7 + 3 (9.56 vs 5.95 months


Elderly AML not fit for intensive treatment

Venetoclax with Aza or decitabine

Low dose cytarabine with venetoclax


IDH1 (ivosedinib) and IDH2 inhibitor Enasedinib can be used in this space although unclear if better than venetoclax based therapy




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