Consensus Recommendations for the Management of AML in Saudi Arabia
Posted: Thursday, September 16, 2021
Ahmed Alaskar, MD, of the Ministry of the National Guard—Health Affairs, Riyadh, Saudi Arabia, and colleagues reviewed existing epidemiologic data and developed consensus guidelines for managing Saudi Arabian patients with acute myeloid leukemia (AML). Their recommendations, which were published in JCO Global Oncology, seemed to parallel the recent international guidelines.
“The development of local guidelines would unify the management approach of AML,” the investigators commented. “[It would also] optimize early patient referral.”
To identify studies reporting epidemiology, treatment patterns, and outcomes in Saudi Arabia, as well as current advances in treatment, a panel of 10 experts conducted a literature review. The panel appeared to agree that the local literature may not represent the epidemiology in Saudi Arabia. Therefore, the panel members recommended a national and unified registry and suggested broadening the relationship between governmental health sectors and pharmaceutical industries to increase clinical trials. As a result, patients with early-stage disease may have increased access to the latest pharmaceuticals and novel compounds.
To reduce the duration of hospital visits and cost burden, the panel recommended implementing outpatient programs and strategies to measure the economic impact of AML. In addition, they suggested establishing a local central testing laboratory to expedite diagnostic and genetic testing, standardize results, and decrease the cost of external tests.
If apheresis is unavailable or delayed, hydroxyurea or induction chemotherapy may be used to treat AML presenting with hyperleukocytosis. The 7+3 induction regimen remains the treatment of choice in patients with newly diagnosed AML who are fit for intensive chemotherapy. Those who are unfit should be administered nonintensive therapy. According to the panel, in patients with relapsed or refractory AML, treatment should be based on fitness for intensive chemotherapy.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.