机构：[1]Leukemia Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH.[2]Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.[3]Leukemia Division, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA.[4]Institute of Medical Sciences, Department of Medicine, University of Toronto, Toronto, ON, Canada.[5]Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.[6]Odette Cancer Centre, Division of Medical Oncology and Hematology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.[7]Division of Hematology, The Ohio State University Comprehensive Cancer Center, Columbus, OH.[8]Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, NY.[9]Department of Medicine, School of Medicine, Duke University, Durham, NC.[10]National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.[11]Division of Hematology, Mayo Clinic, Rochester, MN.[12]Grand River Regional Cancer Centre, Kitchener, ON, Canada.[13]Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.[14]Division of Hematology/Oncology, Department of Medicine, University of Rochester, Rochester, NY.[15]Department of Internal Medicine, University of Toronto, Toronto, ON, Canada.[16]Health Science Center, Department of Clinical Medicine, Universidad de Guadalajara, Guadalajara, Mexico[17]The Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China.四川大学华西医院
Older adults with acute myeloid leukemia (AML) represent a vulnerable population in whom disease-based and clinical risk factors, patient goals, prognosis, and practitioner- and patient-perceived treatment risks and benefits influence treatment recommendations.
These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about management of AML in older adults.
ASH formed a multidisciplinary guideline panel that included specialists in myeloid leukemia, geriatric oncology, patient-reported outcomes and decision-making, frailty, epidemiology, and methodology, as well as patients. The McMaster Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline-development process, including performing systematic evidence reviews (up to 24 May 2019). The panel prioritized clinical questions and outcomes according to their importance to patients, as judged by the panel. The panel used the GRADE approach, including GRADE's Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment.
The panel agreed on 6 critical questions in managing older adults with AML, mirroring real-time practitioner-patient conversations: the decision to pursue antileukemic treatment vs best supportive management, the intensity of therapy, the role and duration of postremission therapy, combination vs monotherapy for induction and beyond, duration of less-intensive therapy, and the role of transfusion support for patients no longer receiving antileukemic therapy.
Treatment is recommended over best supportive management. More-intensive therapy is recommended over less-intensive therapy when deemed tolerable. However, these recommendations are guided by the principle that throughout a patient's disease course, optimal care involves ongoing discussions between clinicians and patients, continuously addressing goals of care and the relative risk-benefit balance of treatment.
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外文
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
大类|2 区医学
小类|2 区血液学
最新[2023]版：
大类|1 区医学
小类|2 区血液学
第一作者：
第一作者机构：[1]Leukemia Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH.[*1]Leukemia Program, Cleveland Clinic, 9500 Euclid Ave, Cleveland,OH 44195
通讯作者：
通讯机构：[1]Leukemia Program, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH.[*1]Leukemia Program, Cleveland Clinic, 9500 Euclid Ave, Cleveland,OH 44195
推荐引用方式(GB/T 7714)：
Sekeres Mikkael A,Guyatt Gordon,Abel Gregory,et al.American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults.[J].Blood advances.2020,4(15):3528-3549.doi:10.1182/bloodadvances.2020001920.
APA：
Sekeres Mikkael A,Guyatt Gordon,Abel Gregory,Alibhai Shabbir,Altman Jessica K...&Brignardello-Petersen Romina.(2020).American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults..Blood advances,4,(15)
MLA：
Sekeres Mikkael A,et al."American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults.".Blood advances 4..15(2020):3528-3549
医学