Biological versus Clinical Risk Factors in Acute Myeloid Leukemia: Is There a Winner?

Abstract

We present a case of a patient with a three-month history of peripheral blood cytopenia without a confirmed diagnosis of myelodysplastic syndrome, who developed a favourable-risk acute myeloid leukemia (AML), according to the European Leukemia Net (ELN) criteria. The patient achieved a complete remission with incomplete platelet recovery (CRi) after induction. The patient achieved the morphological CR after the first consolidation and completed the first-line treatment with a syngeneic stem cell transplantation (SCT). A disease relapse occurred after one year of CR (blast cell count in the bone marrow 15%), and the patient was offered a haplo-SCT, which he refused due to personal reasons. In this paper, we discuss the interplay between clinical and biological risk factors in non-high-risk AML patients and speculate that some old clinical risk factors (e.g., age of the patient, achievement of CR after induction, and previous history of myelodysplastic syndrome) may still impact on the treatment decision algorithm of some of these patients.

Feasibility of Leukemia-Derived Exosome Enrichment and Co-isolated dsDNA Sequencing in Acute Myeloid Leukemia Patients: A Proof of Concept for New Leukemia Biomarkers Detection

“…Immunophenotypic, cytogenetic and molecular analyses are conventionally used for AML characterization and classification, which are mainly based on the presence/absence of specific chromosomal rearrangements and fusion genes. AML characterization is fundamental in driving the therapeutic strategy [ 17 , 18 ] and monitoring the Minimal Residual Disease (MRD) [ 19 , 20 , 21 ]. For a long time, the knowledge of the molecular heterogeneity of AML only allowed a better understanding of the disease pathogenesis or an improved risk stratification of AML patients.…”