Prognosis and treatment in acute myeloid leukemia: a comprehensive review

Abstract

Acute myeloid leukemia (AML) is a heterogeneous disorder that is characterized by clonal expansion of immature "blast cells" in the bone marrow and peripheral circulation, resulting in bone marrow failure and inefficient erythropoiesis. The identification of numerous recurrent genetic mutations such as NPM1, CEBPA, and FLT3-ITD has stratified AML into favorable, intermediate, and adverse-risk groups, respectively, along with a cytogenetic profile that carries a considerably different prognosis among these groups. For post-induction treatment, cytogenetics and genetic mutation testing continue to be vital prognostic tools. Despite advancements, including an increased understanding of biology and new drug targets, the cornerstone of treatment still consists of a combination of cytarabine- and anthracycline-based regimens. The majority of patients eventually relapse and die of the disease, especially the elderly population. This review describes the prognosis of different molecular markers and the major recent advancements in the treatment of AML.