Journal of Leukemia
Open Access
ISSN: 2329-6917
ISSN: 2329-6917
Abhit Singh
Acute Myelogenous Leukemia (AML) is an aggressive hematologic malignancy characterized by clonal proliferation of myeloid precursors with impaired differentiation. This review provides a comprehensive overview of AML etiology, molecular pathophysiology, current treatment strategies, and emerging therapies, with a focus on United States clinical practice. We detail known risk factors for AML, including antecedent hematologic disorders, genetic predispositions, environmental and iatrogenic exposures, while noting most cases are de novo without a clear cause. The complex molecular biology of AML is discussed, highlighting key cytogenetic abnormalities and mutations (FLT3, NPM1, TP53, IDH1/2, DNMT3A, etc.) that drive leukemogenesis and inform prognostic risk stratification. Standard induction chemotherapy (e.g. 7+3 cytarabine plus anthracycline) and consolidation with high-dose cytarabine or allogeneic Hematopoietic Stem Cell Transplant (HSCT) remain central to therapy for fit patients. Supportive care measures are crucial for managing cytopenias and treatment complications. We review recent therapeutic advances, including targeted small molecules (FLT3 and IDH inhibitors, BCL-2 inhibitor venetoclax) and immunotherapies (antibody-drug conjugates, bispecific T-cell engagers, CAR-T cells, checkpoint inhibitors), as well as experimental radioimmunotherapy approaches. Five-year survival outcomes are presented by age and genetic risk, underscoring the disparity between younger patients (~40%-45% survival) and older adults (<15%), and between favorable-risk (~70%) and adverse-risk (~20%-25%) disease. Ongoing clinical trials and investigational agents in the AML pipeline are reviewed, such as novel epigenetic modifiers and immune-based therapies. We also provide tables comparing therapeutic regimens, risk stratification, and survival outcomes, and include figures illustrating key molecular pathways and treatment algorithms. Through extensive literature review and up-to-date data, we aim to inform clinicians and researchers about the current state of AML management and future directions in this rapidly evolving field.
Published Date: 2025-05-26; Received Date: 2025-04-25