This handout is for acute leukemia (aml / all / apl). Your care team identified this based on: leukocytosis with circulating blasts on smear.
Other reasons your team may use this plan: pancytopenia + blasts; bleeding / dic (concern for apl); hyperleukocytosis (wbc >100k) — leukostasis emergency.
Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.
| Medication | Starting dose | How | When | What it does |
|---|---|---|---|---|
| all_trans_retinoic_acid | 45 mg/m²/day PO divided BID | PO | BID | Lo-Coco NEJM 2013; do NOT wait for confirmation; differentiation syndrome prophylaxis with steroid |
| arsenic_trioxide | 0.15 mg/kg/day IV | IV | daily until remission then consolidation | Lo-Coco NEJM 2013 — chemo-free for low/intermediate; QTc monitoring |
| prednisone | 0.5 mg/kg PO daily | PO | daily | Prevent dyspnea/fever/edema syndrome |
| idarubicin | 12 mg/m²/d × 4 days | IV | days 2,4,6,8 | High-risk APL adds anthracycline |
Plan: Subtype-driven induction (ELN 2022 AML / NCCN ALL / NCCN APL)
Call 911 or go to the nearest emergency room right away if you have:
Consolidation + maintenance per protocol; MRD assessment; survivorship + late-effect screening
Guideline: ELN 2022 AML Recommendations (Döhner et al, Blood 2022) + 2024 ELN less-intensive-therapy risk refinement; APL0406 ATRA+arsenic (Lo-Coco NEJM 2013, final JCO 2016); VIALE-A azacitidine+venetoclax (DiNardo NEJM 2020); ELIANA tisagenlecleucel CAR-T (Maude NEJM 2018); NCCN AML/ALL/APL