Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is the term given to a group of leukemias from precursors of myeloid, erythroid, megakaryocytic and monocytic lineages. Clonal transformation occurs due to genetic mutations as well as chromosomal rearrangements. Leukemic cells are classified according to morphology and cytogenetics. The age-adjusted incidence of AML is approximately 3.4/100,000, with incidence rising with age.

Outcomes are dependent on several factors including age, karyotype, mutational status and co-morbidities. Younger patients do well with 60-80% achieving complete remission. However only 20-30% will end up having long-term disease-free survival. In older adults, 40-55% achieve complete remission.

Cytogenetic aberrations increase with age which negatively impacts prognosis in older patients. Treatment consists of chemotherapy in separate phases. Induction therapy is standard. However once remission occurs, additional post-remission therapy is usually required to ensure long-term disease-free survival. The development of targeted therapies has taken over the AML agenda.