DR COLE: I have, also, a slightly different question about once people get through their induction when you move into consolidation. How important is it to maintain timing and intensity versus looking at the patient? Maybe they’re a little borderline to start their next round of consolidation. Is it okay to wait a week or more because they just need another week off to rally before their next round? Do you worry about 5 weeks in between consolidations? How do you guys handle that?

DR STONE: I think that’s a very individualized thing for which there’s really no data. Obviously we all learned in fellowship that dose intensity is important for many types of curable neoplasms. And I would apply the same thing to AML, at least chemosensitive AML. Chemoresistant AML you probably just don’t even want to give it. But in chemosensitive AML, like you’re trying to cure an inversion 16 patient, I would be as dose intensive as possible, obviously allowing for space to recover.

My own practice is to wait at least 2 weeks from count recovery between cycles to give them a chance to — when their neutrophil count’s 500 and their platelet count’s 100,000, I count about 2 weeks. And then I give it right away. But that’s just 1 arbitrary style I’ve worked into my practice.

Module 1: Current and future approaches to targeted therapy for acute myeloid leukemia (AML)

Module 2: Other clinical issues in AML management

Module 3: Case discussions