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Co-management strategies for acute myeloid leukemia patients in the community setting

The treatment landscape for acute myeloid leukemia (AML) has changed substantially in recent years. The introduction of newer therapies, including oral agents, less myelosuppressive agents, and parenteral regimens suitable for outpatient administration, has made it feasible for select patients to re...

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Autores principales: Benton, Christopher, Grunwald, Michael R., Safah, Hana, Kasner, Margaret
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791081/
https://www.ncbi.nlm.nih.gov/pubmed/36578924
http://dx.doi.org/10.3389/fonc.2022.1060912
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author Benton, Christopher
Grunwald, Michael R.
Safah, Hana
Kasner, Margaret
author_facet Benton, Christopher
Grunwald, Michael R.
Safah, Hana
Kasner, Margaret
author_sort Benton, Christopher
collection PubMed
description The treatment landscape for acute myeloid leukemia (AML) has changed substantially in recent years. The introduction of newer therapies, including oral agents, less myelosuppressive agents, and parenteral regimens suitable for outpatient administration, has made it feasible for select patients to receive therapy in the outpatient setting and in community practices. Thorough patient evaluation (including molecular testing), planned supportive care (eg, transfusion support, antimicrobial prophylaxis), and vigilant patient monitoring (for tumor lysis syndrome and adverse events) by a multidisciplinary team are required for successful management of patients both in the community and at specialized leukemia centers. Some patients are unable or unwilling to travel to larger academic centers for treatment, and treatment of AML in the community setting may have potential advantages compared to less conveniently located academic/leukemia centers. This includes reduction of financial hardship for patients and their families and often better opportunities for family/caregiver support. Additionally, partnership between community practices and academic/leukemia centers is often crucial to optimizing AML management for many patients, as collaboration may facilitate access to additional expertise and trials, multidisciplinary teams for supportive care, easier transition to hematopoietic cell transplantation, and access to sophisticated molecular testing. In this review, we discuss AML treatment and management in the community setting, available therapies, and circumstances in which a referral to and co-management with an academic/leukemia center is more strongly recommended.
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spelling pubmed-97910812022-12-27 Co-management strategies for acute myeloid leukemia patients in the community setting Benton, Christopher Grunwald, Michael R. Safah, Hana Kasner, Margaret Front Oncol Oncology The treatment landscape for acute myeloid leukemia (AML) has changed substantially in recent years. The introduction of newer therapies, including oral agents, less myelosuppressive agents, and parenteral regimens suitable for outpatient administration, has made it feasible for select patients to receive therapy in the outpatient setting and in community practices. Thorough patient evaluation (including molecular testing), planned supportive care (eg, transfusion support, antimicrobial prophylaxis), and vigilant patient monitoring (for tumor lysis syndrome and adverse events) by a multidisciplinary team are required for successful management of patients both in the community and at specialized leukemia centers. Some patients are unable or unwilling to travel to larger academic centers for treatment, and treatment of AML in the community setting may have potential advantages compared to less conveniently located academic/leukemia centers. This includes reduction of financial hardship for patients and their families and often better opportunities for family/caregiver support. Additionally, partnership between community practices and academic/leukemia centers is often crucial to optimizing AML management for many patients, as collaboration may facilitate access to additional expertise and trials, multidisciplinary teams for supportive care, easier transition to hematopoietic cell transplantation, and access to sophisticated molecular testing. In this review, we discuss AML treatment and management in the community setting, available therapies, and circumstances in which a referral to and co-management with an academic/leukemia center is more strongly recommended. Frontiers Media S.A. 2022-12-12 /pmc/articles/PMC9791081/ /pubmed/36578924 http://dx.doi.org/10.3389/fonc.2022.1060912 Text en Copyright © 2022 Benton, Grunwald, Safah and Kasner https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Benton, Christopher
Grunwald, Michael R.
Safah, Hana
Kasner, Margaret
Co-management strategies for acute myeloid leukemia patients in the community setting
title Co-management strategies for acute myeloid leukemia patients in the community setting
title_full Co-management strategies for acute myeloid leukemia patients in the community setting
title_fullStr Co-management strategies for acute myeloid leukemia patients in the community setting
title_full_unstemmed Co-management strategies for acute myeloid leukemia patients in the community setting
title_short Co-management strategies for acute myeloid leukemia patients in the community setting
title_sort co-management strategies for acute myeloid leukemia patients in the community setting
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9791081/
https://www.ncbi.nlm.nih.gov/pubmed/36578924
http://dx.doi.org/10.3389/fonc.2022.1060912
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