Prognostic Factors in AML

Itzykson, Raphaël; Cerrano, Marco; Esteve, Jordi

doi:10.1007/978-3-030-72676-8_7

Cited by 2 publications

(3 citation statements)

References 452 publications

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“…The role of several gene mutations has been explored in the last decade, mostly with inconclusive results [ 3 , 128 , 129 ].…”

Section: Genetic Risk Profilementioning

confidence: 99%

“…Finally, most studies exploring the prognostic value of MRD in AML are heterogeneous in terms of the patient population (age and AML subtypes), the timing of MRD assessment, and the source (peripheral blood vs. bone marrow) [ 146 ]. However, in 2017, the ELN introduced MRD response as a subcategory of CR, acknowledging that patients achieving MRD-negative CR after intensive chemotherapy experience better outcomes compared to MRD-positive ones [ 125 ], and in 2018, the first ELN MRD consensus guidelines addressed comprehensively the role of MRD in AML [ 3 , 147 ]. Indeed, a large 2020 meta-analysis including 81 publications with 11151 AML patients treated with intensive chemotherapy clearly demonstrated the strength of the association between MRD and survival outcomes, regardless of patient- and disease-related factors and methodologic variables.…”

Section: Measurable Residual Diseasementioning

confidence: 99%

“…Here, we review the established AML prognostic factors, and we discuss the emerging ones, focusing on innovative comprehensive approaches aiming to integrate and weight them. Summarizing the prognostic risk stratification of AML in specific contexts, such as children or relapsed patients, goes beyond the scope of this review, and these subjects have been recently reviewed elsewhere [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

Boscaro¹,

Urbino²,

Catania³

et al. 2023

Cancers

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An accurate estimation of AML prognosis is complex since it depends on patient-related factors, AML manifestations at diagnosis, and disease genetics. Furthermore, the depth of response, evaluated using the level of MRD, has been established as a strong prognostic factor in several AML subgroups. In recent years, this rapidly evolving field has made the prognostic evaluation of AML more challenging. Traditional prognostic factors, established in cohorts of patients treated with standard intensive chemotherapy, are becoming less accurate as new effective therapies are emerging. The widespread availability of next-generation sequencing platforms has improved our knowledge of AML biology and, consequently, the recent ELN 2022 recommendations significantly expanded the role of new gene mutations. However, the impact of rare co-mutational patterns remains to be fully disclosed, and large international consortia such as the HARMONY project will hopefully be instrumental to this aim. Moreover, accumulating evidence suggests that clonal architecture plays a significant prognostic role. The integration of clinical, cytogenetic, and molecular factors is essential, but hierarchical methods are reaching their limit. Thus, innovative approaches are being extensively explored, including those based on “knowledge banks”. Indeed, more robust prognostic estimations can be obtained by matching each patient’s genomic and clinical data with the ones derived from very large cohorts, but further improvements are needed.

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“…The role of several gene mutations has been explored in the last decade, mostly with inconclusive results [ 3 , 128 , 129 ].…”

Section: Genetic Risk Profilementioning

confidence: 99%

Section: Measurable Residual Diseasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

Boscaro¹,

Urbino²,

Catania³

et al. 2023

Cancers

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Evolving Therapeutic Approaches for Older Patients with Acute Myeloid Leukemia in 2021

Urbino

Secreto

Olivi

et al. 2021

Cancers

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Acute myeloid leukemia (AML) in older patients is characterized by unfavorable prognosis due to adverse disease features and a high rate of treatment-related complications. Classical therapeutic options range from intensive chemotherapy in fit patients, potentially followed by allogeneic hematopoietic cell transplantation (allo-HCT), to hypomethylating agents or palliative care alone for unfit/frail ones. In the era of precision medicine, the treatment paradigm of AML is rapidly changing. On the one hand, a plethora of new targeted drugs with good tolerability profiles are becoming available, offering the possibility to achieve a prolonged remission to many patients not otherwise eligible for more intensive therapies. On the other hand, better tools to assess patients’ fitness and improvements in the selection and management of those undergoing allo-HCT will hopefully reduce treatment-related mortality and complications. Importantly, a detailed genetic characterization of AML has become of paramount importance to choose the best therapeutic option in both intensively treated and unfit patients. Finally, improving supportive care and quality of life is of major importance in this age group, especially for the minority of patients that are still candidates for palliative care because of very poor clinical conditions or unwillingness to receive active treatments. In the present review, we discuss the evolving approaches in the treatment of older AML patients, which is becoming increasingly challenging following the advent of new effective drugs for a very heterogeneous and complex population.

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Prognostic Factors in AML

Cited by 2 publications

References 452 publications

Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

Modern Risk Stratification of Acute Myeloid Leukemia in 2023: Integrating Established and Emerging Prognostic Factors

Evolving Therapeutic Approaches for Older Patients with Acute Myeloid Leukemia in 2021

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