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Favourable-Risk AML — RACP Adult Medicine MCQ

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ModerateHaematologyFavourable-Risk AMLRACP Adult Medicine

A 55-year-old man with newly diagnosed acute myeloid leukaemia presents with pancytopenia (Hb 72 g/L, WCC 1.8 × 10⁹/L with neutrophils 0.3, platelets 25 × 10⁹/L). Bone marrow shows 65% blasts positive for CD34, CD13, CD33, and MPO. Cytogenetics show t(8;21). What is the most appropriate initial treatment?

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Correct answer: C — Intensive chemotherapy (7+3: cytarabine + daunorubicin)

AML with t(8;21) is favourable-risk cytogenetics (core binding factor AML). Standard induction is intensive 7+3 chemotherapy (7 days cytarabine + 3 days anthracycline). t(8;21) AML has good response rates and may not require transplant in CR1. Consolidation with high-dose cytarabine is standard for favourable-risk AML.

Reference: ALLG – 2024 – AML Treatment Guidelines; ELN 2022