‘Acute myeloid leukemia: a comprehensive review and 2016 update’

Острый миелоидный лейкоз: всеобъемлющий обзор и обновленные данные за 2016 год
Ivan de Kouchkovsky, Maher Abdul‐Hay
2016-07-01

FLT3-ITD mutationsacute myeloid leukemiaallogeneic stem cell transplantationcytarabine-anthracycline therapycytogenetic risk stratification
Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with an incidence of over 20 000 cases per year in the United States alone. Large chromosomal translocations as well as mutations in the genes involved in hematopoietic proliferation and differentiation result in the accumulation of poorly differentiated myeloid cells. AML is a highly heterogeneous disease; although cases can be stratified into favorable, intermediate and adverse-risk groups based on their cytogenetic profile, prognosis within these categories varies widely. The identification of recurrent genetic mutations, such as FLT3-ITD, NMP1 and CEBPA, has helped refine individual prognosis and guide management. Despite advances in supportive care, the backbone of therapy remains a combination of cytarabine- and anthracycline-based regimens with allogeneic stem cell transplantation for eligible candidates. Elderly patients are often unable to tolerate such regimens, and carry a particularly poor prognosis. Here, we review the major recent advances in the treatment of AML.
1
AML is highly heterogeneous, and cytogenetic risk categories do not fully predict prognosis because outcomes vary substantially within each group.
2
AML is the most common acute leukemia in adults, with more than 20,000 cases diagnosed annually in the United States.
3
Chromosomal translocations and mutations affecting hematopoietic proliferation and differentiation drive accumulation of poorly differentiated myeloid cells.
4
Recurrent mutations including FLT3-ITD, NPM1, and CEBPA improve individualized prognostic assessment and help guide treatment decisions.
5
Standard treatment remains cytarabine- and anthracycline-based chemotherapy, supplemented by allogeneic stem cell transplantation for eligible patients; elderly patients often cannot tolerate these approaches and have particularly poor outcomes.

Acute myeloid leukemia (AML)

the genetic heterogeneity, prognostic stratification, and treatment advances in AML

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2016-07-01
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Ivan de Kouchkovsky
Maher Abdul‐Hay
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