Updated NCCN Guidelines for AML Include Risk Stratification to Assist in Treatment Selection

Updated NCCN Guidelines for AML Include Risk Stratification to Assist in
Treatment Selection

The National Comprehensive Cancer Network (NCCN) recently updated the NCCN
Guidelines for Acute Myeloid Leukemia (AML), the most common acute leukemia
affecting adults. Noteworthy updates include the incorporation of risk
stratification based on white blood cell count, the alternative to use cord
blood in allogeneic stem cell transplants, and new treatment options for
adults over the age of 60 with AML

FORT WASHINGTON, Pa., Oct. 19 /PRNewswire-USNewswire/ -- The National
Comprehensive Cancer Network (NCCN) recently made updates to the NCCN Clinical
Practice Guidelines in Oncology(TM) for Acute Myeloid Leukemia, a cancer that
starts inside the bone marrow and the most common acute leukemia affecting
adults. Among the updates to the NCCN Guidelines is the addition of risk
stratification, based on white blood cell (WBC) count to assist with the
selection of treatment for patients with acute promyelocytic leukemia (APL), a
subtype of AML.

New pages were added to the NCCN Guidelines to address the therapy options for
APL patients with low risk or high risk disease as defined by WBC count
status. The updated NCCN Guidelines recommend that patients with APL who can
tolerate anthracycline therapy should have their WBC count assessed prior to
therapy to classify them as high risk, which constitutes having a WBC count
greater or equal to 10,000, or low/intermediate risk, which is having a WBC
count of less than 10,000.

The updated NCCN Guidelines note that APL should be treated according to one
of the regimens established from clinical trials. They also emphasize the
importance of using these regimens consistently and not mix induction from one
with consolidation from the other.

For patients with AML who are candidates for an allogeneic stem cell
transplant - a procedure in which a person receives blood-forming stem cells
from a donor with matched tissue type - the updated NCCN Guidelines now list
umbilical cord blood as an alternative source if an appropriate sibling or
unrelated donor is not available.

Recommendations for induction chemotherapy for patients with AML consider age
60 as a therapeutic divergence point and therefore, the NCCN Guidelines
consider patients older or younger than 60 years old separately. However, for
older patients (>60 years) with AML, the updated NCCN Guidelines recommend
that patient performance status, in addition to adverse features and comorbid
conditions need to be considered when selecting treatment in addition to a
patient's chronological age alone.

In the updated NCCN Guidelines, 5-azacytidine (Vidaza(R), Celgene Corporation)
and decitabine (Dacogen(R), Eisai Inc.), have been added as low intensity
treatment options and clofarabine (Clolar(R), Genzyme Corporation) as
intermediate intensity treatment option for patients with AML who are 60 years
or older. All these agents have a category 2B designation.

Although AML is a relatively rare disease, an estimated 12,810 new cases will
be diagnosed in the United States in 2009, its incidence appears to be
increasing as the population ages.

NCCN Clinical Practice Guidelines in Oncology(TM) are developed and updated
through an evidence-based process with explicit review of the scientific
evidence integrated with expert judgment by multidisciplinary panels of
physicians from NCCN Member Institutions. The most recent version of this and
all the NCCN Guidelines are available free of charge at NCCN.org.

About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of
21 of the world's leading cancer centers, is dedicated to improving the
quality and effectiveness of care provided to patients with cancer. Through
the leadership and expertise of clinical professionals at NCCN Member
Institutions, NCCN develops resources that present valuable information to the
numerous stakeholders in the health care delivery system. As the arbiter of
high-quality cancer care, NCCN promotes the importance of continuous quality
improvement and recognizes the significance of creating clinical practice
guidelines appropriate for use by patients, clinicians, and other health care
decision-makers. The primary goal of all NCCN initiatives is to improve the
quality, effectiveness, and efficiency of oncology practice so patients can
live better lives.

The NCCN Member Institutions are: City of Hope Comprehensive Cancer Center,
Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center - Massachusetts
General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center,
Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer
Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson
Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney
Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H.
Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL;
Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer
Center & Research Institute, Tampa, FL; The Ohio State University
Comprehensive Cancer Center - James Cancer Hospital and Solove Research
Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman
Cancer Center at Barnes-Jewish Hospital and Washington University School of
Medicine, St. Louis, MO; St. Jude Children's Research Hospital/University of
Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center,
Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center,
Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer Center, San
Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor,
MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The
University of Texas M. D. Anderson Cancer Center, Houston, TX; and
Vanderbilt-Ingram Cancer Center, Nashville, TN.

For more information, visit NCCN.org.

SOURCE National Comprehensive Cancer Network

Megan Martin, NCCN, +1-215-690-0576, martin@nccn.org