How I treat AML incorporating the updated classifications and guidelines

Abstract

The European LeukemiaNet recently revised both the clinical (2022) and measurable residual disease testing (2021) guidelines for acute myeloid leukemia (AML). The updated World Health Organization and International Consensus Classification for myeloid neoplasms were also published in 2022. Together, these documents update the classification, risk stratification, prognostication, monitoring recommendations, and response assessment of patients with AML. Increased appreciation of the genetic drivers of AML over the past decade and our increasingly sophisticated understanding of AML biology have been translated into novel therapies and more complex clinical treatment guidelines. Somatic genetic abnormalities and germ line predispositions now define and guide treatment and counseling for the subtypes of this hematologic malignancy. In this How I Treat article, we discuss how we approach AML in daily clinical practice, considering the recent updates in the context of new treatments and discoveries over the past decade.

Graphical abstract

Figure 1.

Timeline of FDA approvals for the treatment of AML. CRi, complete remission with incomplete count recovery; dx, diagnosed; FDA, Food and Drug Administration; IC, intensive chemotherapy; LDAC, low dose cytarabine; MDS, myelodysplasia; Mut, mutated; R/R, relapsed and refractory.