NCCN肿瘤治疗指南

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Clinical Practice Guidelines in Oncology – v.2.2005
Acute Myeloid Leukemia
Version 2.2005
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NCCN
®
Practice Guidelines in Oncology – v.2.2005
Acute Myeloid Leukemia
NCCN Categories of Consensus: All recommendations are Category 2A unless otherwise specified. See NCCN Categories of Consensus
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Clinical Trials: The NCCN believes that the best management for any cancer patient is in a clinical trial. Participation in clinical trials is especially encouraged. To find clinical trials online at NCCN member institutions, click here: nccn.org/clinical_trials/physician.html
Version 2.2005, 05/31/05 © 2005 National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.
Guidelines Index AML Table of Contents MS, References
NCCN Acute Myeloid Leukemia Panel Members
* Margaret R. O’Donnell, MD/Chair
City of Hope Cancer Center Frederick R. Appelbaum, MD Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance Maria R. Baer, MD Roswell Park Cancer Institute John C. Byrd, MD Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at The Ohio State University Steven E. Coutre, MD Stanford Hospital and Clinics Lloyd E. Damon, MD UCSF Comprehensive Cancer Center Harry P. Erba, MD, PhD University of Michigan Comprehensive Cancer Center Eli Estey, MD The University of Texas M. D. Anderson Cancer Center James Foran, MD University of Alabama at Birmingham Comprehensive Cancer Center Lori Maness, MD UNMC Eppley Cancer Center at The Nebraska Medical Center Peter G. Maslak, MD Memorial Sloan-Kettering Cancer Center Michael Millenson, MD Fox Chase Cancer Center Joseph O. Moore, MD Duke Comprehensive Cancer Center Donna Przepiorka, MD, PhD St. Jude Children's Research Hospital/University of Tennessee Cancer Institute Hussain I. Saba, MD, PhD H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida Paul Shami, MD Huntsman Cancer Institute at the University of Utah B. Douglas Smith, MD The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Richard Stone, MD Dana-Farber/Partners CancerCare
Manuscript References
Guidelines Index Print the Acute Myeloid Leukemia Guideline
These guidelines are a statement of consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The National Comprehensive Cancer Network makes no representations nor warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any way. These guidelines are copyrighted by National Comprehensive Cancer Network. All rights reserved. These guidelines and the illustrations herein may not be reproduced in any form without the express written permission of NCCN. ©2005.
NCCN
DIAGNOSIS
®
Practice Guidelines in Oncology – v.2.2005
WORKUP
Acute Myeloid Leukemia
CLASSIFICATION/STAIN ANALYSIS Immunophenotyping (+) for ³ 2 myeloid markers and (+) for typically < 2 lymphoid markers g or Myeloperoxidase (+) or Nonspecific esterase (+) or Butyrate (+) Myeloperoxidase (–) Nonspecific Esterase (–) TdT (+) or Immunophenotyping (+) for ³ 2 lymphoid markers and (+) for < 2 myeloid markersg TdT (+)
NCCN
®
Practice Guidelines in Oncology – v.2.2005
Acute Myeloid Leukemia
Guidelines Index AML Table of Contents MS, References
Table of Contents
NCCN Acute Myeloid Leukemia Panel Members Workup and Classification (AML-1) APL, Treatment Induction and Response (AML-2) AML, Treatment Induction (AML-4) AML, Post-Induction Therapy (Standard-dose cytarabine) (AML-5) AML, Post-Induction Therapy (High-dose cytarabine) (AML-6) AML, Surveillance (AML-8) AML, Relapse (AML-8) Evaluation and Treatment of CNS Leukemia (AML-A) Supportive Care (AML-B) Response Criteria for Acute Myeloid Leukemia (AML-C) Monitoring During Therapy (AML-D)
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* Martin S. Tallman, MD
Robert H. Lurie Comprehensive Cancer Center of Northwestern University
* Writing Committee Member
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Version 2.2005, 05/31/05 © 2005 National Comprehensive Cancer Network, Inc. All rights reserved. These guidelines and this illustration may not be reproduced in any form without the express written permission of NCCN.
Guidelines Index AML Table of Contents MS, References
Acute leukemiaa,b,c
· H&P · CBC, platelets, differential, chemistry profile · PT, PTT, fibrinogen · Bone marrow with cytogenetics (mandatory) · Immunophenotyping or cytochemistry d · HLA typing (in patients considered potential BMT candidates)e · Cardiac scan if prior cardiac history or prior anthracycline use · Central venous access of choice · FLT3 mutation evaluation is recommended If clinically indicated: · Begin alternative donor search if patient has secondary AML, an antecedent hematologic disorder, or known poor-risk cytogenetics and there is no sibling donor · Lumbar puncture (LP), if symptomatic f (category 2B for asymptomatic)
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