Question

How will you decide treatment after first cycle of Aza+Ven therapy?

Hint:

The decision to continue Aza+Ven therapy after the first cycle depends on the patient's response (CR/PR) and the tolerability of the regimen.

Answer 1

Step 1: Assessing Response to First Cycle.
After the first cycle of Aza+Ven therapy, the patient's response must be carefully evaluated. Key factors to consider include: 1. Bone Marrow Response: The first step is to assess the degree of remission or cytogenetic response using bone marrow biopsy. Complete remission (CR) or partial remission (PR) is considered a positive response. If no response is seen, alternative therapies should be considered.
2. Peripheral Blood Counts: A reduction in blast percentage in the peripheral blood indicates a good response. If counts remain high, further adjustments may be required.
3. Side Effects and Tolerability: The patient's tolerance to treatment is crucial. Monitoring for adverse effects such as neutropenia, thrombocytopenia, or infections is necessary to determine whether therapy needs to be adjusted.

Step 2: Further Treatment Decisions.
1. Continued Aza+Ven: If the patient achieves CR or PR with manageable side effects, continuation of the Aza+Ven regimen for further cycles is recommended.
2. Alternative Therapy: If there is no significant response or if the patient experiences intolerable side effects, alternative therapies, such as intensive chemotherapy or other targeted therapies, may need to be considered.