SOHO 2024 | Diagnosing and treating AML: the role of mutational profiling

We have a lot of therapies that have been approved for AML in the last couple of years with potentially menin inhibitors being the new kid on the block for options for patients. But what the community physicians need to know and what they need to do is they need to make sure that in every new acute myeloid leukemia patient that they are performing mutational profiling in advance, potentially, of starting therapy in patients if at all possible and in a timely fashion because not only are some of these mutations the target of some of these new therapies, they could be prognostic. There’s new classification systems, the ELN and for MDS, the IPSSM, and those rely solely on mutations to predict and to prognosticate for both AML and MDS. So if you are lacking and you are not performing that next-gen sequencing and mutational profiling, you’re potentially inaccurately predicting the outcomes of those patients and potentially not making available to those patients some of the benefits of these oral targeted therapies for these patients. In addition, we know that some of those mutations like p53 pertain a dismal outcome with standard therapy. So those are patients that might need to be referred earlier for clinical trials and or allogeneic stem cell transplantation. So the community physicians need to remember that, that it’s not one disease that we’re treating, but potentially subsets of different biological disease types for which we might need to know the unique outcome and the therapeutic options.