The NCCN Guidelines for the management of acute myeloid leukemia (AML) have, for the most part, remained unchanged from 2020, with some shifts in emphasis, fine-tuning, and several important updates in the 2021 version. The guidelines now emphasize physiologic age rather than chronologic age, and recommend that fit patients should receive intensive chemotherapy. Actionable genetics are being used to guide selection of therapy. Minimal residual disease assessment after induction therapy is now incorporated in the guidelines. New therapeutic options include oral azacitidine and combination venetoclax + azacitidine, and preliminary evidence suggests that IDH inhibitors will come to the fore in the treatment of AML.
Disclosures: Dr. Perl has disclosed receiving honoraria from and serving as a scientific advisor for AbbVie, Inc., Actinium Pharmaceuticals, Astellas Pharma US, Inc., Celgene Corporation, Daiichi-Sankyo Co., Genentech, Inc., Loxo Oncology, Inc., Sumitomo Dainippon, and Syndax; receiving grant/research support from AbbVie, Inc., Astellas Pharma US, Inc., Daiichi-Sankyo Co., and Fujifilm Corporation; and receiving consulting fees from AbbVie, Inc., Astellas Pharma US, Inc., OncoNova, BeatAML LLC, Daiichi-Sankyo Co., and Forma Therapeutics.