Acute Chemotherapy Administration and Complications

Administration of chemotherapy for acute myelogenous leukemia (AML) should be initiated promptly in patients presenting with extremely high white blood count (WBC), especially if leukostasis is clinically demonstrated. In patients with suspected acute promyelocytic leukemia (APL), detailed examination of peripheral blood smear, rapid initiation of differentiating therapy, and supportive care for common complications such as disseminated intravascular coagulation (DIC) should be prioritized. Therapy in less proliferative non-APL and stable patients should be carefully risk-adapted based on availability of karyotypic and genomic data. In this chapter, we discuss important advances in management of young and older patients with AML. Additionally, we review major complications resulting from administration of intravenous chemotherapy and newly approved targeted drugs.