Patient selection: acute myeloid leukemia
Criteria for unfitness to receive intensive chemotherapy - one or more of the following:
(1) age > 75 years
(2) severe heart disease
(2a) congestive heart failure with LVEF <= 50%
(2b) documented cardiomyopathy with LVEF <= 50%
(3) documented pulmonary disease with one or more of the following:
(3a) DLco <= 65%
(3b) FEV1 <= 65% of predicted
(3c) dyspnea at rest
(3d) need for supplemental oxygen
(3e) pleural neoplasm
(3f) uncontrolled lung neoplasm
(4) severe renal disease
(4a) age > 60 years on dialysis
(4b) uncontrolled renal carcinoma
(5) severe liver disease with one or more of the following:
(5a) liver cirrhosis with Child B or C
(5b) serum transaminase levels > 3 times the upper limit of normal (ULN) AND age > 60 years
(5c) biliary tree carcinoma
(5d) uncontrolled liver carcinoma
(5e) acute viral hepatitis
(6) active infection resistant to anti-infective therapy (refractory)
(7) current mental illness or cognitive impairment
(7a) psychiatric hospitalization, institutionalization or intensive outpatient management
(7b) current cognitive status that produces dependence not controlled by the caregiver
(8) ECOG performance status 3 or 4 not related to leukemia
(9) any other comorbidity that is incompatible with intensive chemotherapy (physician opinion)
