Original Title: Algorithme de traitement de la leucémie myéloïde aiguë

Authors' objectives: At the request of the Programme québécois de cancérologie (PQC) of the Ministère de la Santé et des Services sociaux (MSSS), the Institut national d’excellence en santé et en services sociaux (INESSS) created an algorithm for the treatment of acute myeloid leukemia. It is specifically designed for use in the adult population.

Authors' results and conclusions: RESULTS : The algorithm’s Web format is divided into three main levels: the algorithms per se, which map the care pathways (Level 1), the clinical practice recommendations (Level 2), and the evidence and a discussion (Level 3). There are clickable links for navigating between the three levels. Levels 1 and 2 are presented in this publication. The care pathways (Level 1) are preceded by the European LeukemiaNet (ELN) classification, which divides AML into three main prognostic categories (favorable risk, intermediate risk and adverse risk), which are based on different cytogenetic and molecular abnormalities. These risk categories have a bearing on the choice of treatment. The main Health Canada-approved treatments for AML (chemotherapy and targeted therapies) are presented in the algorithm, together with their indications and coverage status and are followed by the related treatment protocols. The different care pathways (algorithms, Level 1) are presented according to the patient’s ability to receive intensive treatment or not and the type of AML they have (newly diagnosed AML [de novo or secondary] or recurrent/refractory and its cytogenetic/molecular profile): • Candidates for intensive treatment – FLT3-mutated AML • Candidates for intensive treatment – CD33+ AML with favorable- or intermediaterisk cytogenetics • Candidates for intensive treatment – Other newly diagnosed de novo AML • Candidates for intensive treatment – Secondary AML (MRC-AML and t-AML) • Patients who are not candidates for intensive treatment • Recurrent or refractory AML. Also presented are the different induction, consolidation and maintenance therapies, as well as the salvage and palliative therapies and the supportive care (antifungal prophylaxis). The algorithm contains the ELN’s definitions of response to treatment and situates allogeneic hematopoietic stem cell transplantation across the different care pathways. However, specific details on the management of patients referred for a transplantation are not provided.

Authors' methods: This algorithm is a decision-making tool containing all of INESSS’s recommendations and the best evidence concerning the treatment of AML in a dynamic Web format. It was developed in collaboration with clinicians and is intended to facilitate the work of health professionals involved in AML care pathways. The algorithm is updated on an ongoing basis.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/algorithme-de-traitement-de-la-leucemie-myeloide-aigue.html

Year Published: 2024

URL for published report: https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/algorithme-de-traitement-de-la-leucemie-myeloide-aigue.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: L'Institut national d'excellence en sante et en services sociaux (INESSS)