Managing Toxicities in Patients With AML

EP: 1.Overview of Pathophysiology of and Progression of AML

EP: 2.Risk Classification Systems in AML

EP: 3.Key Patient Factors to Consider in AML Treatment Decisions

EP: 4.Provider Perspectives on Biggest Unmet Needs in AML Care

EP: 5.Social Determinants to AML Treatment Approach

EP: 6.Latest NCCN Guidelines on the Standard of Care for Patients With AML

EP: 7.Patient Eligibility for Transplant, Induction, and Consolidation in AML Treatment

EP: 8.Venetoclax and the Impact on Management of Older Patients With AML

EP: 9.Combination Therapies in AML Treatment Approach

EP: 10.Tracking the Shifting Treatment Landscape of AML

EP: 11.Expert Perspectives on IDH Inhibitors in AML Treatment

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EP: 12.Managing Toxicities in Patients With AML

Patients receiving modern acute myeloid leukemia (AML) treatments face complex toxicity management challenges that require careful individualization of drug dosing, duration, and monitoring approaches. The introduction of venetoclax has revolutionized treatment effectiveness but created new management considerations around optimal treatment duration, timing of bone marrow biopsies, and prevention of prolonged blood count suppression. Patients benefit when health care teams perform day-21 bone marrow biopsies to assess remission status and guide venetoclax duration adjustments, preventing unnecessarily prolonged treatment courses that increase toxicity risks.

Geographic variations in infection risks significantly impact patient management strategies, with fungal infection rates varying substantially between treatment centers in different regions. Patients in areas with higher environmental fungal exposure may require different prophylactic approaches compared to those in lower-risk regions, highlighting the need for individualized supportive care plans. Health care teams must balance the benefits of antifungal prophylaxis against potential drug interactions with venetoclax and other targeted therapies that could compromise treatment effectiveness.

Growth factor support decisions have evolved as treatment approaches have changed, with patients in remission now receiving growth factors more liberally to maintain treatment schedules and prevent dangerous delays between treatment cycles. The shift away from concerns about stimulating leukemia cells with growth factors in patients achieving remission allows for more proactive supportive care. Patients require comprehensive education about infection precautions, bleeding risks, and when to seek immediate medical attention, while health care teams must develop standardized protocols for venetoclax dose modifications, treatment interruptions, and supportive care measures that can be consistently applied across different treatment settings.