Materiały źródłowe

• #1 Can Acute Myeloid Leukemia (AML) Be Prevented? | American Cancer Society

  https://www.cancer.org/cancer/types/acute-myeloid-leukemia/causes-risks-prevention/prevention.html

  Its not clear what causes most cases of acute myeloid leukemia (AML). Many people with AML dont have risk factors that can be changed. […] Avoid smoking […] Avoid exposure to cancer-causing chemicals […] Smoking is by far the biggest controllable risk factor for AML, and quitting offers the best chance to reduce a persons risk of AML. […] Avoiding known cancer-causing chemicals, such as benzene and formaldehyde, might lower the risk of getting AML.

• #1 Explore Acute myeloid leukaemia Prevention Risk factors and Prevention Measures at HCG Oncology

  https://www.hcgoncology.com/types-of-cancers/acute-myeloid-leukaemia-prevention/

  Several factors increase the risk of acute myeloid leukemia. […] Acute myeloid leukemia prevention measures include quitting smoking and avoiding exposure to harmful chemicals. […] Avoiding smoking is one of the most important acute myeloid leukemia prevention measures. Quitting smoking significantly lowers the risk of various types of cancer, including AML, as it avoids exposure to harmful chemicals present in cigarette smoke. […] Avoiding prolonged exposure to these chemicals is another important acute myeloid leukemia prevention measure. […] Acute myeloid leukemia prevention measures include quitting smoking and avoiding exposure to harmful chemicals, especially at the occupation site. […] However, certain steps, such as quitting smoking and avoiding exposure to carcinogens, lower the AML risk.

• #1 Acute Myeloid Leukemia (AML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/6212-acute-myeloid-leukemia-aml

  No, you cant prevent acute myeloid leukemia. Experts know that genetic mutations cause acute myeloid leukemia but they dont know what triggers them. They do know about risk factors that may cause AML. Risk factors you can modify include: […] Smoking, including exposure to second-hand smoke. If you smoke, try to quit. If you live or work around someone who smokes, try to limit how much time you spend with them when theyre smoking. […] Long-term exposure to certain carcinogenic chemicals, particularly benzene and formaldehyde. If you work around these carcinogens, be sure you follow all safety precautions, such as wearing protective clothing.

• #1 Acute Myeloid Leukemia Screening/Prevention | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/leukemia/acute-myeloid-leukemia/acute-myeloid-leukemia-screeningprevention

  There is convincing evidence that excess body fat substantially increases the risk for many types of cancer. While much of the cancer-related nutrition information cautions against a high-fat diet, the real culprit may be an excess of calories. […] High fruit and vegetable consumption has been associated with a reduced risk for developing at least 10 different cancers. This may be a result of potentially protective factors such as carotenoids, folic acid, vitamin C, flavonoids, phytoestrogens and isothiocyanates. These are often referred to as antioxidants. […] Higher levels of physical activity may reduce the incidence of some cancers. According to researchers at Harvard, if the entire population increased their level of physical activity by 30 minutes of brisk walking per day (or the equivalent energy expenditure in other activities), we would observe a 15% reduction in the incidence of colon cancer.

• #1 Acute Myeloid Leukemia Screening/Prevention

  https://www.texasoncology.com/types-of-cancer/leukemia/acute-myeloid-leukemia/acute-myeloid-leukemia-screeningprevention

  High fruit and vegetable consumption has been associated with a reduced risk for developing at least 10 different cancers. […] Higher levels of physical activity may reduce the incidence of some cancers. […] Workers in the chemical or petroleum industry need regular screening. Screening consists of a routine blood count, which is part of an annual physical examination. It is important to realize that the average age for developing AML is over 65 years. People over the age of 65 should probably have a physical examination with routine blood counts every 6 months.

• #1 Could acute myeloid leukemia be prevented? – Boston Children’s Answers

  https://answers.childrenshospital.org/preventing-acute-myeloid-leukemia/

  Acute myeloid leukemia (AML), a blood cancer affecting both adults and children, requires more than one genetic “hit” to develop. […] In new research, Armstrong and his colleagues suggest that interfering with this second hit, using a compound that is in preclinical studies and appears so far to be safe, could prevent AML before it gets started. […] The idea is that you would screen people and follow those who have clonal hematopoiesis, and treat people who develop the second mutation, says Armstrong. […] When they introduced the second hit, a mutation in the gene NPM1, the mice went on to develop leukemia. But if these mice were treated early with a compound called VTP-50469, the premalignant blood cells stopped multiplying and leukemia never developed. […] We eradicated the cells that would ultimately become leukemia cells, says Armstrong.

• #1 Updates in infection risk and management in acute leukemia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7727589/

  Patients with acute myeloid leukemia (AML) have qualitative and quantitative deficits in granulocytes predisposing to bacterial and fungal infections. […] Antimicrobial prophylaxis is used to reduce the risk of life-threatening bacterial and fungal infections, particularly in patients with disruption of the gut mucosa. […] Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in patients with acute leukemia. Patients with acute myeloid leukemia (AML) in particular are at increased risk of IFIs due to profound and prolonged duration of neutropenia, as well as the use of purine analogs in treatment. […] Posaconazole is now recommended for primary fungal prophylaxis in patients with AML undergoing induction chemotherapy. […] Although mold-active antifungal prophylaxis has become standard of care during neutropenic periods of most AML treatment regimens, there is no similar standardized recommendation during acute lymphoblastic leukemia (ALL) treatment. […] As new antileukemic chemotherapy- or immune-based therapeutics are introduced into the armamentarium, vigilance in determining associated infection risk needs to be delineated so that appropriate caution and prophylaxis are considered.

• #1 Clinical Challenges: Optimizing Infection Prophylaxis in AML | MedPage Today

  https://www.medpagetoday.com/clinical-challenges/soho-aml/94528

  Better management of infectious complications in acute myeloid leukemia (AML) has improved care over the past 50 years. […] Prophylactic targeting of potentially life-threatening viral, bacterial, and fungal pathogens is therefore a significant aspect of preventing infection in AML patients — especially since some of the potent new targeted agents such as the BCL2 inhibitor venetoclax (Venclexta), alone or in combination with other cytotoxics, can exacerbate myelosuppression. […] There is no one-size-fits-all approach to prophylaxis, however, according to Matthew McCarthy, MD, and Thomas Walsh, MD, both of Weill Cornell Medical Center in New York City, writing in a recent overview of prophylaxis during AML induction therapy. […] Three-pronged prophylaxis against infections — antibacterial, antiviral, and antifungal — is therefore the norm for all AML patients undergoing treatment at MD Anderson, said Kadia.

• #1 Effects of Levofloxacin Prophylaxis in Pediatric Patients With Acute Myeloid Leukemia, Relapsed Acute Lymphoblastic Leukemia, or Patients Undergoing Hematopoietic Stem Cell Transplant

  https://jhoponline.com/issue-archive/2023-issues/august-2023-vol-13-no-4/effects-of-levofloxacin-prophylaxis-in-pediatric-patients-with-acute-myeloid-leukemia-relapsed-acute-lymphoblastic-leukemia-or-patients-undergoing-hematopoietic-stem-cell-transplant

  Prophylactic antibiotics are often used in pediatric patients for the treatment of acute myeloid leukemia (AML) and relapsed acute lymphoblastic leukemia (ALL), and for those undergoing hematopoietic stem cell transplant (HSCT) who are receiving intensive chemotherapy. […] To prevent infections, prophylactic antibiotics are often used during periods of neutropenia in pediatric patients with AML, relapsed ALL, and those undergoing autologous or allogeneic HSCT. The use of prophylactic agents is based on the current Infectious Diseases Society of America (IDSA) guidance specific to pediatric cancer and HSCT. […] IDSA recommends the consideration of systemic antibacterial prophylaxis in children with AML and relapsed ALL if they are receiving intensive chemotherapy that is expected to result in severe neutropenia, which is defined as an absolute neutrophil count (ANC) of 500 cells/L for at least 7 days.

• #1 Infection Prophylaxis in Acute Myeloid Leukemia

  https://www.onclive.com/view/infection-prophylaxis-in-acute-myeloid-leukemia

  In terms of prophylaxis. So in terms of infection prevention, dealing with neutropenic fever, NCCN Guidelines, other things; things that you’ve seen that folks have found helpful. […] I think the NCCN Guidelines are a great example of where actually putting on paper a standard treatment regimen is helpful, so that groups that don’t have as much experience can rely on the experience of others to help. […] The IDSA also has guidelines about treatment of neutropenic fever, when to add certain antibiotics and when not to overtreat, and when not to use MRSA treatment, for example, for prolonged periods of time and so on. […] The policy at our institution, we use quinolones for bacterias. We give valaciclovir for covering viral, and then azoles, essentially because azoles are orals to be given.

• #1 Clinical Challenges: Optimizing Infection Prophylaxis in AML | MedPage Today

  https://www.medpagetoday.com/clinical-challenges/soho-aml/94528

  The important thing, Kadia stressed, is to start patients on all three types of prophylaxis and in the case of antifungals, use the newer mold-active ones. […] One problem with prophylaxis of any type is the ever-present phenomenon of antimicrobial resistance. […] The management of infection risk has evolved steadily over time, with no sudden monumental shift, he continued. […] But at MD Anderson we see such a high volume of leukemia patients with so many complications and we see so much improvement in outcomes with prophylaxis that we’ve adopted it universally.

• #1 Antifungal prophylaxis in adult patients with acute myeloid leukaemia treated with novel targeted therapies: a systematic review and expert consensus recommendation from the European Hematology Association – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35483397/

  On the basis of improved overall survival, treatment guidelines strongly recommend antifungal prophylaxis during remission induction chemotherapy for patients with acute myeloid leukaemia. […] Antifungal prophylaxis is recommended with moderate strength in most settings, and strongly recommended if the novel acute myeloid leukaemia agent is administered in combination with intensive induction chemotherapy. […] This is the first guidance supporting clinical decision making on antifungal prophylaxis in recipients of novel targeted drugs for acute myeloid leukaemia. Future studies including therapeutic drug monitoring will need to determine the role of dosage adjustment of novel antileukaemic drugs during concomitant administration of CYP3A4-inhibiting antifungals with respect to adverse effects and remission status.

• #1 Infection Prophylaxis in Acute Myeloid Leukemia

  https://www.onclive.com/view/infection-prophylaxis-in-acute-myeloid-leukemia

  The posaconazole preventative data were very strong, but clearly things need to be individualized. […] I think the data on prevention are clear that posaconazole and voriconazole are better than fluconazole for sure. […] I think you raise an excellent point: that prevention is so key in this setting. […] Nipping those things in the bud is really essential because otherwise then we just have the mortality, not only from the disease, but really from the infectious causes that are related. […] As we look at individualized medicine, I think that part two will evolve. […] I think the more options we have, the better the outcomes. […] Even with an antifungal therapy, as Rafael mentioned, in somebody who cannot take oral medicine, what do you do? […] I certainly was very impressed by the 2007 New England Journal of Medicine article, the role of posaconazole compared to fluconazole and voriconazole was very strong.

• #1 Updated guidelines on antifungal prophylaxis in adult patients with acute myeloid leukemia

  https://aml-hub.com/medical-information/updated-guidelines-on-antifungal-prophylaxis-in-adult-patients-with-acute-myeloid-leukemia

  Patients diagnosed with acute myeloid leukemia (AML) and receiving intensive chemotherapy treatment are at high risk of invasive fungal disease. […] While antifungal prophylaxis is strongly recommended during remission induction chemotherapy, optimal management of fungal disease in patients receiving novel targeted treatments is uncertain. […] The strength of evidence for antifungal prophylaxis is low and is not generally recommended for adult patients receiving azacitidine monotherapy. […] Antifungal prophylaxis may be considered; however, it should be limited to patients with neutropenia at treatment initiation, or those who have received intensive chemotherapy. […] Standard prophylaxis is not recommended but may be considered for patients with neutropenia at treatment initiation, or those who have received intensive chemotherapy.

• #1 Use of Primary Prophylaxis with G-CSF in Acute Myeloid Leukemia Patients Undergoing Intensive Chemotherapy Does Not Affect Quality of Response

  https://www.mdpi.com/2077-0383/14/4/1254

  Efforts to mitigate these risks have included prophylactic antimicrobial strategies and supportive care measures. […] Granulocyte colony-stimulating factor (G-CSF) has been widely used in oncology to manage chemotherapy-induced neutropenia. […] In the context of AML, G-CSF has been studied as a potential supportive care measure to reduce the duration of neutropenia and the risk of infectious complications following intensive chemotherapy. […] Starting from 2019, given the progressive increase in the number of patients with AML referred to our center, in the attempt to reduce hospitalization and allow more efficient inpatient flow management, we began routine administration of G-CSF (Filgrastim) as primary prophylaxis for febrile neutropenia (FN). […] Our study adds additional insights into this ongoing debate.

• #1 Use of Primary Prophylaxis with G-CSF in Acute Myeloid Leukemia Patients Undergoing Intensive Chemotherapy Does Not Affect Quality of Response

  https://www.mdpi.com/2077-0383/14/4/1254

  Use of Primary Prophylaxis with G-CSF in Acute Myeloid Leukemia Patients Undergoing Intensive Chemotherapy Does Not Affect Quality of Response […] The objective of our study was to evaluate the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) as primary prophylaxis in adult patients with acute myeloid leukemia (AML) undergoing intensive chemotherapy. […] G-CSF administration significantly reduced the duration of neutropenia (median 14 vs. 18 days, p < 0.05) and length of hospitalization (median 28 vs. 35 days, p < 0.05), in both induction and consolidation therapy. [...] Our findings support the safety of G-CSF in AML patients, demonstrating no adverse impact on treatment response. [...] G-CSF abbreviated the duration of neutropenia and hospitalization, highlighting its potential clinical and cost-effective role in AML treatment.

• #1

  https://link.springer.com/article/10.1007/s10147-023-02465-0

  Although granulocyte colony-stimulating factor (G-CSF) reduces the incidence, duration, and severity of neutropenia, its prophylactic use for acute myeloid leukemia (AML) remains controversial due to a theoretically increased risk of relapse. […] The present study investigated the effects of G-CSF as primary prophylaxis for AML with remission induction therapy. […] Although G-CSF significantly shortened the duration of neutropenia, primary prophylaxis with G-CSF did not correlate with infection-related mortality. Moreover, primary prophylaxis with G-CSF did not affect disease progression/recurrence, overall survival, or adverse events, such as musculoskeletal pain. […] Therefore, the use of G-CSF as primary prophylaxis can be considered for adult AML patients with remission induction therapy who are at a high risk of infectious complications.

• #1

  https://link.springer.com/article/10.1007/s10147-023-02465-0

  Primary prophylaxis with G-CSF did not correlate with infection-related mortality in adult AML patients receiving remission induction therapy; however, G-CSF significantly shortened the duration of neutropenia. Furthermore, primary prophylaxis with G-CSF did not affect disease progression/recurrence, OS, or adverse events, such as musculoskeletal pain. Therefore, the use of G-CSF as a primary prophylactic during induction therapy only needs to be considered for adult AML patients who are at a high risk of infectious complications.

• #1 Managing Differentiation Syndrome Associated with Treatment for AML

  https://jhoponline.com/issue-archive/2024-issues/february-2024-vol-14-no-1/managing-differentiation-syndrome-associated-with-treatment-for-aml

  The incorporation of differentiation syndrome prophylaxis into APL chemotherapy regimens has contributed to decreased incidence and mortality related to differentiation syndrome. […] If corticosteroid prophylaxis is not included in the treatment protocol, it should be strongly considered for patients with APL and a WBC count of 10,000 cells/L. […] The prophylaxis of differentiation syndrome is not well defined for small molecule inhibitors for the treatment of AML because clinical trials did not use corticosteroids as prophylaxis. […] The use of prolonged corticosteroids as prophylaxis for differentiation syndrome may pose an infection risk in patients who often present with prolonged neutropenia. […] The corticosteroid-related adverse events to monitor include hypertension, hyperglycemia, insomnia, and gastrointestinal bleeding.

• #1 Managing Differentiation Syndrome Associated with Treatment for AML

  https://jhoponline.com/issue-archive/2024-issues/february-2024-vol-14-no-1/managing-differentiation-syndrome-associated-with-treatment-for-aml

  Cytoreduction should be considered in high-risk patients as a way to mitigate differentiation syndrome. […] In AML treatments (excluding APL), cytoreduction should be considered in the setting of leukocytosis per treatment protocol or institutional standard. […] There is currently no treatment recommendation for prophylactic corticosteroids in patients with AML who are receiving small molecule inhibitors.

• #1 Venous thromboembolism in patients with acute myeloid leukemia: development of a predictive model | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-024-00607-6

  Patients with acute myeloid leukemia (AML) are at increased risk of venous thromboembolic events (VTE). However, thromboprophylaxis is largely underused. […] We developed a novel and convenient tool that may assist clinicians in identifying patients whose VTE risk is high enough to warrant thromboprophylaxis. […] This model could identify patients whose VTE risk is high enough to warrant thromboprophylaxis. […] The high incidence of VTE in acute leukemias raises the question of whether primary VTE thromboprophylaxis is needed to prevent this complication. […] Consequently, determining VTE development risk factors in patients with acute leukemias will allow clinicians to risk-stratify patients and individualize patient surveillance and anticoagulant prophylaxis. […] Our study investigated the predictive value of 38 disease-, therapy-, and patient-related parameters for VTE development.

• #1 Venous thromboembolism in patients with acute myeloid leukemia: development of a predictive model | Thrombosis Journal | Full Text

  https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-024-00607-6

  The new International Initiative on Thrombosis and Cancer guidelines recommend thromboprophylaxis for patients with cancer at high risk for VTE development and low risk for bleeding. […] Our model showed a positive net benefit for probability thresholds between 8 and 20%. […] We developed a novel and simple tool to assist clinicians with identifying those patients with AML who might benefit from thromboprophylaxis.

• #1 Relapse Prevention in Acute Myeloid Leukemia: The Role of Immunotherapy with Histamine Dihydrochloride and Low-Dose Interleukin-2

  https://www.mdpi.com/2072-6694/16/10/1824

  Relapse Prevention in Acute Myeloid Leukemia: The Role of Immunotherapy with Histamine Dihydrochloride and Low-Dose Interleukin-2 […] Maintenance with histamine dihydrochloride associated with low-dose interleukin-2 (HDC/LD-IL-2), both administered by subcutaneous injections, has been approved for patients in CR who are not candidates for upfront allo-SCT. […] Immunotherapy with HDC/LD-IL-2 may represent an emerging treatment option for remission maintenance in AML. […] Improved maintenance therapy, defined as extended treatment beyond the initial chemotherapy to avoid relapse in CR or prolong the duration of remission, is thus a partly unmet need in AML. […] HDC/LD-IL-2 was evaluated as maintenance immunotherapy in a phase 3 study in 320 AML patients in the post-consolidation phase.

• #1 Relapse Prevention in Acute Myeloid Leukemia: The Role of Immunotherapy with Histamine Dihydrochloride and Low-Dose Interleukin-2

  https://www.mdpi.com/2072-6694/16/10/1824

  The phase 3 trial reached the primary endpoint of improved LFS in all randomly assigned patients (n = 320, hazard ratio [HR] 0.71, p = 0.008) and the secondary endpoint of LFS in patients in CR1 (n = 261, HR 0.69, p < 0.01). [...] The Re:Mission trial results thus suggest that activation of anti-leukemic lymphocytes contributed to the clinical benefit of HDC/LD-IL-2. [...] HDC/LD-IL-2 is an immunotherapeutic strategy to reduce the risk of relapse in the post-remission phase of AML. [...] According to post hoc analyses of phase 3 trial results, HDC durably reduces relapse risk among patients with AML of normal karyotype and in patients with leukemic cells responsive to initial chemotherapy; in these subgroups, treatment with HDC/LD-IL-2 largely doubles the likelihood of long-term relapse-free survival with a similar magnitude of efficacy for overall survival. [...] The clinical benefit of HDC/LD-IL-2 is age-dependent, with preferred efficacy in younger patients (<60 years old).

• #1

  https://journals.lww.com/hemasphere/fulltext/2022/07000/antifungal_prophylaxis_in_acute_myeloid_leukemia_.5.aspx

  Therefore, the strongest recommendation for antifungal prophylaxis remains for a mold-active triazole-based approach. […] If the recommendation was either for or against antifungal prophylaxis, this should guide the treating physician to taking the decision context-dependent, that is, according to the patients individual scenario, such as expected duration of neutropenia, history of IFD or local epidemiology of IFD. […] The published recommendations also have limitations that remain a future challenge in the context of diversifying treatment settings for AML, emerging fungal pathogens and antifungal resistance, and different management approaches to prevent IFD. […] Further investigations in the field may comprise RCTs to evaluate efficacy of antifungal prophylaxis in patients with AML not treated with intensive RIC, as well as the assessment of real-life utilization of antifungal prophylaxis in patients with AML.

• #1 Prophylactic Measures During Induction for Acute Myeloid Leukemia.

  https://vivo.weill.cornell.edu/display/pubid28251490

  PURPOSE OF REVIEW: Improved management of infectious complications of acute myeloid leukemia (AML) has contributed substantially to the success of care over the past half century. An important approach to reducing infectious complications during the induction period of chemotherapy involves the use of prophylactic antibacterial, antiviral, and antifungal agents targeting likely pathogens. […] There is not a one-size-fits-all approach to prophylaxis; every patient undergoing induction therapy should be evaluated individually and within the context of local microbiologic epidemiology and host risk factors. Pharmacologic and non-pharmacologic interventions as well as novel diagnostic platforms can help mitigate the risk of life-threatening infection in patients with AML who undergo induction chemotherapy.

• #2 Acute Myeloid Leukemia (AML): Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/6212-acute-myeloid-leukemia-aml

  No, you cant prevent acute myeloid leukemia. Experts know that genetic mutations cause acute myeloid leukemia but they dont know what triggers them. They do know about risk factors that may cause AML. Risk factors you can modify include: […] Smoking, including exposure to second-hand smoke. If you smoke, try to quit. If you live or work around someone who smokes, try to limit how much time you spend with them when theyre smoking. […] Long-term exposure to certain carcinogenic chemicals, particularly benzene and formaldehyde. If you work around these carcinogens, be sure you follow all safety precautions, such as wearing protective clothing.

• #2 Acute Myeloid Leukemia Screening/Prevention | Nebraska Hematology Oncology – Cancer Care Treatment Blood Disorders Clinical Trials Lincoln Nebraska (NE)

  https://www.yourcancercare.com/types-of-cancer/leukemia/acute-myeloid-leukemia/acute-myeloid-leukemia-screeningprevention

  Cancer is largely a preventable illness. Two-thirds of cancer deaths in the U.S. can be linked to tobacco use, poor diet, obesity, and lack of exercise. All of these factors can be modified. Nevertheless, an awareness of the opportunity to prevent cancer through changes in lifestyle is still under-appreciated. […] The majority of cases of AML cannot be prevented since we do not know the cause. The few cases associated with benzene exposure are preventable with better workplace conditions. The exact number of cases of AML that could be prevented by avoiding exposure to automobiles is unknown, but this is impractical for the majority of people. […] Diet is a fertile area for immediate individual and societal intervention to decrease the risk of developing certain cancers. Numerous studies have provided a wealth of often-contradictory information about the detrimental and protective factors of different foods.

• #2 What Causes Leukemia, Risk Factors and Prevention

  https://www.cancercenter.com/cancer-types/leukemia/risk-factors

  There is no confirmed way to prevent leukemia. Still, it may be possible to help reduce the risk for this type of cancer by making certain lifestyle changes and following healthy habits, including: […] Don’t smoke. Current smokers should seek help to quit. There are lots of free cessation programs available online or in the local community. Keep trying and find what works. […] Keep a healthy body weight. Lose weight if needed. Ask a doctor for advice on how to start a healthy weight loss program. […] Avoid or lower exposure to chemicals that may raise the risk for leukemia, such as benzene and formaldehyde. […] Lower any exposure to pesticides. […] Stay physically active and follow a healthy diet. Both these lifestyle elements have been proven to reduce cancer risk in general.

• #2 Explore Acute myeloid leukaemia Prevention Risk factors and Prevention Measures at HCG Oncology

  https://www.hcgoncology.com/types-of-cancers/acute-myeloid-leukaemia-prevention/

  Several factors increase the risk of acute myeloid leukemia. […] Acute myeloid leukemia prevention measures include quitting smoking and avoiding exposure to harmful chemicals. […] Avoiding smoking is one of the most important acute myeloid leukemia prevention measures. Quitting smoking significantly lowers the risk of various types of cancer, including AML, as it avoids exposure to harmful chemicals present in cigarette smoke. […] Avoiding prolonged exposure to these chemicals is another important acute myeloid leukemia prevention measure. […] Acute myeloid leukemia prevention measures include quitting smoking and avoiding exposure to harmful chemicals, especially at the occupation site. […] However, certain steps, such as quitting smoking and avoiding exposure to carcinogens, lower the AML risk.

• #2 Could acute myeloid leukemia be prevented? – Boston Children’s Answers

  https://answers.childrenshospital.org/preventing-acute-myeloid-leukemia/

  While screening everyone over a certain age for clonal hematopoiesis may not be practical yet, one could imagine screening people who are thought to be at heightened risk for AML, such as those who have had chemotherapy before, or in whom problems in the blood system are suspected. […] The same preventive care concept could potentially also apply to other cancers that involve multiple hits, Armstrong believes. […] If you have a molecule that targets one of the early mutations, that’s really the holy grail: being able to intervene early in the cancer development process.

• #2 Prophylactic Measures During Induction for Acute Myeloid Leukemia.

  https://vivo.weill.cornell.edu/display/pubid28251490

  PURPOSE OF REVIEW: Improved management of infectious complications of acute myeloid leukemia (AML) has contributed substantially to the success of care over the past half century. An important approach to reducing infectious complications during the induction period of chemotherapy involves the use of prophylactic antibacterial, antiviral, and antifungal agents targeting likely pathogens. […] There is not a one-size-fits-all approach to prophylaxis; every patient undergoing induction therapy should be evaluated individually and within the context of local microbiologic epidemiology and host risk factors. Pharmacologic and non-pharmacologic interventions as well as novel diagnostic platforms can help mitigate the risk of life-threatening infection in patients with AML who undergo induction chemotherapy.

• #2 Effects of Levofloxacin Prophylaxis in Pediatric Patients With Acute Myeloid Leukemia, Relapsed Acute Lymphoblastic Leukemia, or Patients Undergoing Hematopoietic Stem Cell Transplant

  https://jhoponline.com/issue-archive/2023-issues/august-2023-vol-13-no-4/effects-of-levofloxacin-prophylaxis-in-pediatric-patients-with-acute-myeloid-leukemia-relapsed-acute-lymphoblastic-leukemia-or-patients-undergoing-hematopoietic-stem-cell-transplant

  If the decision is made to initiate prophylactic antibiotics, IDSA strongly recommends levofloxacin over other fluoroquinolones because it has adequate coverage of viridans streptococci and Pseudomonas species. […] The use of levofloxacin prophylaxis did not result in a significant reduction in the incidence of bacteremia compared with the control group but did show a trend towards the reduction of bacteremia. […] Prophylaxis should still be strongly considered. However, as the use of levofloxacin increases, fluoroquinolone resistance may continue to rise and considerations of an alternative antibiotic treatment for prophylaxis may be necessary.

• #2 Updated guidelines on antifungal prophylaxis in adult patients with acute myeloid leukemia

  https://aml-hub.com/medical-information/updated-guidelines-on-antifungal-prophylaxis-in-adult-patients-with-acute-myeloid-leukemia

  Since the drug-drug interactions are manageable, fungal prophylaxis is recommended, preferably with a triazole, for adult patients treated with venetoclax in combination with a HMA who are at high risk of invasive fungal disease. […] Adult patients who are at high risk of fungal infection during treatment should receive antifungal prophylaxis, preferably posaconazole; however, for those at a lower risk it is only a conditional recommendation, based on patient factors such as neutropenia, or history of fungal disease. […] Prophylaxis with triazoles is considered only in patients at high risk of fungal infection, and the treatment should otherwise be decided on the context of the individual patient. […] If administered as part of a combination therapy, there is a strong recommendation for antifungal prophylaxis.

• #2 Managing Differentiation Syndrome Associated with Treatment for AML

  https://jhoponline.com/issue-archive/2024-issues/february-2024-vol-14-no-1/managing-differentiation-syndrome-associated-with-treatment-for-aml

  Cytoreduction should be considered in high-risk patients as a way to mitigate differentiation syndrome. […] In AML treatments (excluding APL), cytoreduction should be considered in the setting of leukocytosis per treatment protocol or institutional standard. […] There is currently no treatment recommendation for prophylactic corticosteroids in patients with AML who are receiving small molecule inhibitors.

• #2 Relapse Prevention in Acute Myeloid Leukemia: The Role of Immunotherapy with Histamine Dihydrochloride and Low-Dose Interleukin-2

  https://www.mdpi.com/2072-6694/16/10/1824

  The phase 3 trial reached the primary endpoint of improved LFS in all randomly assigned patients (n = 320, hazard ratio [HR] 0.71, p = 0.008) and the secondary endpoint of LFS in patients in CR1 (n = 261, HR 0.69, p < 0.01). [...] The Re:Mission trial results thus suggest that activation of anti-leukemic lymphocytes contributed to the clinical benefit of HDC/LD-IL-2. [...] HDC/LD-IL-2 is an immunotherapeutic strategy to reduce the risk of relapse in the post-remission phase of AML. [...] According to post hoc analyses of phase 3 trial results, HDC durably reduces relapse risk among patients with AML of normal karyotype and in patients with leukemic cells responsive to initial chemotherapy; in these subgroups, treatment with HDC/LD-IL-2 largely doubles the likelihood of long-term relapse-free survival with a similar magnitude of efficacy for overall survival. [...] The clinical benefit of HDC/LD-IL-2 is age-dependent, with preferred efficacy in younger patients (<60 years old).

• #3 Updated guidelines on antifungal prophylaxis in adult patients with acute myeloid leukemia

  https://aml-hub.com/medical-information/updated-guidelines-on-antifungal-prophylaxis-in-adult-patients-with-acute-myeloid-leukemia

  Treatment with a triazole is generally recommended for patients with AML, with posaconazole being the preferred therapeutic. However, the individual medical history of the patient, including previous chemotherapy, duration of neutropenia, and previous history of fungal disease should always be considered prior to prophylaxis.

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