Older patients with acute myeloid leukemia are more likely to exhibit intrinsic disease resistance as well as poor tolerance to therapy and treatment-related mortality. Identifying older patients that may benefit from RIC HSCT requires a thorough review of the scientific literature, assessment of patient populations studied, regimens used, and outcomes achieved. Although some patients benefit greatly from this procedure, few are currently referred for evaluation. This educational program will review the most current, effective treatment strategies for older patients with AML with a focus on optimizing patient selection and supportive care strategies.

Learning Objectives

At the end of this educational activity, participants should be able to:

    Acute myeloid leukemia induction:

  • Explain the relative importance of age, performance status, comorbidity, organ dysfunction, cytogenetics, and molecular markers as predictive factors in selecting patients with AML for induction therapy.
  • Assimilate patient population and outcomes from clinical trials evaluating newer therapies for older patients with AML and apply data to optimize therapy for older patients with AML.
  • Implement a state-of-the-art supportive care regimen to prevent bacterial and fungal infections in patients with AML.
  • Acute myeloid leukemia Transplant:

  • Synthesize the published entry criteria and results for RIC transplant into a coherent and clinically applicable guide to evaluate older patients for eligibility for allogeneic transplant.
  • Explain the impact of patient and disease specific factors that influence allogeneic transplant outcomes. /li>
  • Differentiate outcomes achieved among RIC regimens evaluated for older patients with AML.
  • Assimilate and apply patient population and outcomes data to optimize RIC regimen selection for eligible older patients with AML.
  • Demonstrate the ability to apply current evidence to the post-transplant management of older patients with AML receiving RIC HSCT.
  • Identify strategies to optimize graft-versus-leukemia effect in RIC for AML.


  • Clinical Director, Leukemia Program, Hematology, Massachusetts General Hospital
    Associate Professor of Medicine, Harvard Medical School
  • Director, Bone Marrow Transplant Program, MGH
    Chief, Walter Bauer Firm, Hematology/Oncology Unit, MGH
    Professor of Medicine, Hematology/Oncology, Harvard Medical School

CME Information

Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Elsevier Office of Continuing Medical Education, Massachusetts General Hospital Academy and Reed Medical Education. The Elsevier Office of CME is accreditated by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation
The Elsevier Office of Continuing Medical Education designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Method of Participation
In order to claim credit, participants must complete the following:

  1. Pre-activity self-assessment questions
  2. View the activity
  3. Complete the CME Test and Evaluation. Participants must achieve a score 70% on the CME Test.

Participants can complete the pre-activity self-assessment and CME Test and Evaluation by pressing the continue button below. Upon successful completion of the online tests and evaluation form, you can instantly download and print your certificate of credit. 

Resolution of Conflict of Interest
The EOCME has implemented a process to resolve conflict of interest for each CME activity. In order to help ensure content objectivity, independence, and fair balance, and to ensure that the content is aligned with the interest of the public, the EOCME has resolved the conflict by external content review.

Unapproved/Off-Label Use Disclosure
The EOCME requires CME faculty to disclose to the participants:
1. When products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not US Food and Drug Administration [FDA] approved); and
2. Any limitations on the information presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty may discuss information about pharmaceutical agents that is outside of FDA-approved labeling. This information is intended solely for CME and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

Faculty and Provider Disclosure
As a sponsor accredited by the ACCME, it is the policy of the EOCME to require the disclosure of anyone who is in a position to control the content of an educational activity. All relevant financial relationships with any commercial interests and/or manufacturers must be disclosed to participants at the beginning of each activity. This program was developed by Drs. Karen Ballen, MD, and Thomas Spitzer, MD. Dr. Ballen has no relevant financial relationships to disclose. Dr. Spitzer has no relevant financial relationships to disclose.

Planning Committee Disclosures
Anan Nathif has no financial relationships to disclose.
Timothy Lynch has no financial relationships to disclose.
Sandy Breslow, Elsevier Office of CME, has no financial relationships to disclose.
Mary Ellen Shepard, PhD, Content Reviewer, has no financial relationships to disclose.


CME Inquiries
We encourage participation by all individuals. If you have any special needs or inquiries, please contact the EOCME at for assistance.

Our evidence-based curriculum is supported by an educational grant from Otsuka America Pharmaceutical, Inc.



The following planners of this activity have indicated that neither they nor their families have a significant financial interest or affiliation with the manufacturer of any commercial products or provider of commercial services:

Robert J. Birnbaum, MD, PhD: Planner

John A. Fromson, MD: Planner, reviewer

Anan Nathif, EdM: Planner

Tristan Gorrindo, MD:Planner

Hardware/Software Specifications: 

This internet-based CME activity is best experienced using Internet Explorer 8+, Mozilla Firefox 3+, Safari 4+. This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Adobe Acrobat, Microsoft PowerPoint, and Windows Media Player.

Optimal System Configuration:
Flash Player: Adobe Flash Player 10.1+
Browser: Firefox 3+, Internet Explorer 8.0+, Safari 4.0+, or Google Chrome 7.0+
Operating System: Windows XP+ or Mac OS X 10.4+
Internet Connection: 1 Mbps or higher

Minimum Requirements:
Windows PC:
500-MHz Pentium II; Windows XP or higher; 128 MB RAM; Video Card at least 64MB of video memory; Sound Card at least 16-bit; Macromedia Flash Player 10 or higher, audio playback with speakers for programs with video content; Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Mac OS X 10.3 or higher with latest updates installed; 1.83MHz Intel Core Duo or faster; RAM: 128MB or more; Video Card: at least 64MB of video memory; Sound Card: at least 16-bit



This program has received support in the form of educational grants from the following companies: