Leukemia

AML is treated with intensive chemotherapy. The standard regimen is an anthracycline plus Ara-C (the three plus seven regimen). Following remission, consolidation, often with high-dose ARA-C, is administered. Depending on risk stratification, allogeneic or autologous transplant may be appropriate in selected patients. Acute promyelocytic leukemia (FAB M3) is treated with ATRA in addition to chemotherapy. Induction is followed by consolidation and then a maintenance regimen. There is no benefit from maintenance therapy in the other subtypes of AML.

ALL is treated with an intensive multiagent chemotherapy regimen. Up to six or eight months of intensive therapy is administered followed by maintenance therapy for up to a total of three years of therapy. CNS prophylaxis is an integral component of therapy. Allogeneic transplantation is indicated for patients with high-risk disease in first remission and for selected other patients at the time of relapse.

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