Consolidation treatment

Patients who have achieved complete remission receive consolidation treatment to:

  • Reinforce remission and lessening the risk for relapse
  • Increase patient survival time
  • Consolidation treatment can also be used to achieve a cure or as a bridgeā€‘treatment to an allogeneic stem-cell transplantation (ASCT).
  • Consolidation aims at destroying remaining leukaemia cells in the body and may consist of:
  • Further chemotherapy
  • An ASCT

Consolidation treatment with further chemotherapy, often at higher doses than that used for induction therapy, will depend on the patientā€™s age, their physical fitness, chromosomal abnormalities detected, and importantly their risk of relapse.

For young patients (18-60 years):

  • Low-risk AML: Further consolidation chemotherapy
  • Intermediate-risk AML: 2 to 4 cycles of intermediate-dose cytarabine, with or without ASCT, depending on the chromosome abnormality
  • High-risk AML: ASCT

 

In older adults:

  • Low-risk AML: 2 to 3 cycles of low-dose cytarabine
  • Intermediate- to high-risk AML: Hypomethylating drugs such as decitabine and azacitidine . Hypomethylating drugs inhibit the enzyme DNA methyltransferase which is vital for cell development
  • Both azacitidine and decitabine help induce remission and control the progression of AML. Treatment can be given as required and it is not divided into induction and consolidation treatment.
  • Azacitidine is approved for the treatment of AML patients with 20% to 30% of leukaemia cells in the blood and bone marrow.
  • Decitabine is specifically approved for adult AML patients who cannot have standard induction chemotherapy.
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