Acute Myeloid Leukemia

With the availability of new oral agents and parenteral drugs suitable for outpatient administration, there is increased interest in treating patients with AML in the community rather than referring them to academic centers.

With the rapidly changing AML treatment landscape, the pros and cons of academic vs. community treatment setting should be revisited, and a shared academiccommunity care approach may currently best serve the interests of the majority of patients with AML.

Evolving practices in the management and prevention of infectious risk in acute leukemia suggest the use of antibiotics and antifungals

Consensus states that all patients with AML with febrile neutropenia should receive empiric antibiotics. Though limited data is available regarding de-escalation, a 2009 observational study observed that discontinuation of broad-spectrum antibiotics in hematology patients on fluoroquinolone and fluconazole prophylaxis is safe, provided no infectious etiology is established after 72 hours.

It is also important to note that patients should be managed based on a comprehensive risk assessment considering the net state of immunosuppression and including disease status and prior and current therapies to ensure best prophylaxis and management of infections in patients with AML.