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14 Cards in this Set
- Front
- Back
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What can make a pt. have a higher risk with AML?
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age > 60; chromosomal abberations
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What drugs are used in induction of AML?
what about high risk pts less than 60? |
7 + 3
seven days continuous infusion of cytarabine three days of anthracycline (idarubicin, daunorubicin, mitoxanrone) if pt is high risk and < 60 yrs old can add etopside or high dose cytarabine (6-thioguanine in children) |
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can GMCSF or GCSF be used in induction of AML?
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yes, however it will not improve survival
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what drugs should be used in consolidation of AML?
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for people > 60 or < 60 with no high risk markers one can use:
cytarabine (high dose if < 60 yrs), (+/-) etopside or mitoxantrone and etopside if < 60 yrs and high risk allogenic transplant if donor |
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What drugs for maintanence therapy in AML?
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no maintenance therapy for AML
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Is CNS prophylaxis used in AML?
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only for Peds pts
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what drugs are used for AML relapse?
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autologous transplant; or allogenic if possible
Gemtuzumab ozogamicin (anti-CD33 monoclonal antibody), 16% complete response and 13% partial response adverse rxns are myelosupression and infusion rxns |
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What is APL?
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acute promyelocytic leukemia that is a separate subtype of AML
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What is the translocation abberation in APL?
What is this translocations effect? |
T(15;17)
results in ineffective retinoid receptor, inhibiting cell differentiation |
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What drugs should be used in the induction and consolidation phase of APL?
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anthracyline
+ ATARA (all trans retinoic acid, tretinoin) |
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What does ATARA reduce the risk of?
What does the chemo do to the ATARA? |
DIC (disseminated intravascular coagulation) from the chemo
the chemo reduece the risk of RAS (retinoic acid syndrome) which is hyperleukocytosis syndrome, fever, pulonary infiltrates, respiratory distress, fluid retention |
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What maintenance therapy is used for APL?
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2 yrs ATARA (15days/3months)
daily 6-MP weekly methotrexate |
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what is used in relapse for APL?
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arsenic trioxide (can increase QTc interval and cause hyperleukocytosis)
sometimes arcenic trioxide used immediately after induction before maintenance |
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What threapy should be used in the induction and consolidation of APL?
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anthracycline
and ATARA |
