Genomics in leukaemia in clinical practice: past, present and the future

Acute myeloid leukaemia (AML) is a heterogeneous group of diseases with diverse genetic drivers. The conventional one-size-fits-all approach with chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT) has reached an impasse, and only about 40% of patients can achieve long-term survival. Disease heterogeneities have also hampered the development of effective therapy applicable to the multitude of AML subtypes. Recent advances in cancer genetics and genomics have shed light on the genetic underpinnings of AML and both inter-individual and intra-tumoral heterogeneities. These new pieces of knowledge have begun to impact the management and prognostication of AML. They also provide the foundation for personalized treatment for this group of diseases.