From the Research
Synchronous acute myeloid leukemia (AML) and colorectal cancer (CRC) should be treated with priority given to AML due to its aggressive nature and immediate life-threatening potential, followed by addressing the CRC. The treatment of AML in this context typically involves standard induction therapy, which may include cytarabine and an anthracycline like daunorubicin or idarubicin, as supported by studies such as 1. After achieving remission of AML, treatment for CRC can begin, which may involve surgical resection followed by adjuvant chemotherapy such as FOLFOX, depending on the staging of the CRC. The timing between treatments should allow for bone marrow recovery, usually 4-6 weeks after completing AML therapy, to minimize the risk of excessive toxicity, particularly myelosuppression, as discussed in 2 and 3. Treatment decisions should be individualized based on the patient's age, performance status, cytogenetic profile of the AML, stage of the CRC, and overall health status, with consideration of the latest advancements in AML treatment, including targeted therapies for specific mutations, as noted in 2 and 3. A multidisciplinary team including hematologists, oncologists, and colorectal surgeons should coordinate care to optimize outcomes for both malignancies, taking into account the most recent evidence and guidelines, such as those discussed in 4 and 3. Key considerations include the potential benefits and risks of different treatment approaches, the importance of genetic risk stratification, and the need for careful monitoring and adjustment of treatment plans as needed, as highlighted in 5 and 3.