Optimizing Clinical Decisions in Hematologic Malignancies in the Community Setting—Integrating Updates in AML Care to Practice
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A 62-year-old woman with newly diagnosed AML undergoes a comprehensive genomic analysis. The results reveal a
TP53
mutation with chromosomal aneuploidy and complex karyotype. Her initial evaluation shows no significant comorbidities, and her performance status is good.
Classify the patient as favorable-risk AML and initiate standard 7+3 induction therapy.
Identify the patient as adverse-risk AML and consider hypomethylating agents with venetoclax
Treat as intermediate-risk AML and recommend high-dose cytarabine consolidation post-induction
Defer genomic findings and rely solely on age and comorbidities for treatment decisions
A 62-year-old woman is diagnosed with AML. Genetic testing reveals the presence of mutated NPM1 without
FLT3
-ITD. Based on the 2022 European LeukemiaNet (ELN) risk stratification, how would you classify this patient's risk?
Favorable
Intermediate
Adverse
Cannot be determined without additional information
A 75-year-old woman with newly diagnosed AML is found to have an
IDH1
mutation. She has an ECOG performance status of 2 and a history of congestive heart failure. Which of the following treatment options would be most appropriate for this patient?
Standard "7+3" induction chemotherapy
Ivosidenib monotherapy
Azacitidine + venetoclax
Supportive care only
A 62-year-old man with relapsed AML is started on gilteritinib for FLT3-mutated disease. Two weeks into treatment, he develops fever, dyspnea, and peripheral edema. What is the most appropriate next step in management?
Discontinue gilteritinib permanently
Start empiric antibiotics for presumed infection
Initiate corticosteroids for possible differentiation syndrome
Reduce the dose of gilteritinib by 50%
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