title: Is it time to change conventional consolidation chemotherapy for acute myeloid leukemia in CR1?
abstract: OBJECTIVE
  Choosing the most appropriate postremission therapy (PRT) for a patient with acute myeloid leukemia (AML) in first complete remission remains a challenging task. Factors such as risk for disease relapse, nonrelapse mortality associated with different PRT approaches, donor availability, prospects for salvage should disease relapse, and patient preference all affect PRT choice.
  
  
  RESULTS
  New genetic markers refine AML risk stratification and identify patients within the 'classical' risk groups who may benefit from transplant-based or chemotherapy-based PRT. The use of minimal residual disease in first remission to guide PRT choice and the application of novel, targeted therapies have the potential to alter PRT approaches across AML risk groups. The advent of alternative donor sources, use of reduced intensity regimens, and improved supportive care all affect the availability and safety of transplant-based PRT and challenge the relevance of the older legacy 'donor/no-donor' genetically randomized trials.
  
  
  CONCLUSIONS
  Genetic risk assessment, monitoring of minimal residual disease in first remission, use of targeted agents, and the newer transplant strategies all have the potential to 'personalize' PRT choice in the AML patient. The clinical value of these novel interventions awaits validation in prospective, risk-adapted clinical trials.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
authors.forename: Ofir
authors.initials: O
authors.lastname: Wolach
authors.forename: Richard M
authors.initials: RM
authors.lastname: Stone
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D060830:Consolidation Chemotherapy; D050660:Core Binding Factors / Q000235:genetics / Q000378:metabolism; D003561:Cytarabine / Q000008:administration & dosage; D056572:Histone Deacetylase Inhibitors / Q000627:therapeutic use; D006801:Humans; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D050660:Core Binding Factors; D056572:Histone Deacetylase Inhibitors; D003561:Cytarabine