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Current Treatment Options in Oncology Apr 2020There is increasing awareness that AML is a widely heterogeneous disease, not only based on clinical characteristics and demographics of the patients we treat but also... (Review)
Review
There is increasing awareness that AML is a widely heterogeneous disease, not only based on clinical characteristics and demographics of the patients we treat but also based on the genomics of the disease. Wider accessibility to next-generation DNA sequencing in AML has identified recurrent genetic abnormalities that drive disease biology, define overall prognosis, and predict for response to newly developed target-specific therapies. This knowledge has allowed the field to move away from a "one-size-fits-all" approach in newly diagnosed AML, to a more thoughtful, individualized approachy based on these factors. The first steps in realizing this new approach involve developing systems to efficiently obtain and analyze patient- and disease-related factors prior to starting therapy and having available clinical trials to address each subtype.
Topics: Biomarkers, Tumor; Clinical Decision-Making; Disease Management; Disease Susceptibility; Humans; Leukemia, Myeloid, Acute; Mutation; Precision Medicine
PubMed: 32318829
DOI: 10.1007/s11864-020-0710-x -
Ugeskrift For Laeger Oct 2021Myeloid neoplasms with germ line predisposition (hMN) are likely underdiagnosed and are estimated to constitute a substantial fraction of patients with myelodysplastic... (Review)
Review
Myeloid neoplasms with germ line predisposition (hMN) are likely underdiagnosed and are estimated to constitute a substantial fraction of patients with myelodysplastic syndrome and acute myeloid leukaemia. Correct diagnosis of hMN is vital, as it can influence treatment decisions, facilitate genetic counselling and help identify family members at risk. In this review, we describe the symptoms associated with hMN and present an example of the underlying molecular mechanism. Furthermore, we summarise the current knowledge and recommendations for diagnosis, surveillance and treatment of hMN.
Topics: Adult; Genetic Predisposition to Disease; Germ Cells; Germ-Line Mutation; Humans; Leukemia, Myeloid, Acute; Myelodysplastic Syndromes
PubMed: 34709158
DOI: No ID Found -
Cancer Discovery May 2023For patients with acute myeloid leukemia, DNA sequencing before stem cell transplant can predict the chances of relapse, research shows. Scientists found that NPM1...
For patients with acute myeloid leukemia, DNA sequencing before stem cell transplant can predict the chances of relapse, research shows. Scientists found that NPM1 alterations and/or FLT3 internal tandem duplications that persist after treatment and prior to a stem cell transplant were better predictors of relapse than flow cytometry.
Topics: Humans; Nuclear Proteins; Nucleophosmin; Mutation; Leukemia, Myeloid, Acute; fms-Like Tyrosine Kinase 3; Prognosis
PubMed: 36951475
DOI: 10.1158/2159-8290.CD-NB2023-0021 -
Clinical Laboratory Mar 2023As a rare heterogeneous kind of acute leukemia, mixed-phenotype acute leukemia (MPAL) co-expresses more than one cell lineage and could contain bilineal, biphenotypic,...
BACKGROUND
As a rare heterogeneous kind of acute leukemia, mixed-phenotype acute leukemia (MPAL) co-expresses more than one cell lineage and could contain bilineal, biphenotypic, or a combination. MPAL is classified as T/myeloid, B/myeloid, B/T-lymphoid, and trilineage B/T/myeloid.
METHOD
Here, we report a rare case of T/Myeloid bilineage mixed-phenotype acute leukemia with basophilia.
RESULT
The puzzling morphological features are due to two distinct kinds of blasts have put hematologists into a dilemma. The diagnosis of T/myeloid MPAL with basophilia was established based on integrated diagnostics.
CONCLUSIONS
To date, no case of a patient diagnosed with T/Myeloid bilineage MPAL with basophilia has been reported. The case focuses on the importance of an integrated diagnostic work-up, with a challenging morphological presentation and crucial role for flow cytometry.
Topics: Humans; Leukemia, Myeloid, Acute; Acute Disease; Leukocytes; Phenotype; Flow Cytometry; Immunophenotyping
PubMed: 36912307
DOI: 10.7754/Clin.Lab.2022.220726 -
Hematology/oncology Clinics of North... Apr 2020Secondary acute myeloid leukemia (sAML) is a complex diagnosis that includes AML caused by either an antecedent hematologic disease (AML-AHD) or from previous treatment... (Review)
Review
Secondary acute myeloid leukemia (sAML) is a complex diagnosis that includes AML caused by either an antecedent hematologic disease (AML-AHD) or from previous treatment with chemotherapy or radiation. This disease carries a poor prognosis and is historically chemorefractory; additionally, often patients are ineligible for standard chemotherapy because of advanced age and other comorbidities. The advances of molecular diagnostics and reclassification of World Health Organization criteria have aided in the categorization of this disease. This article describes the etiology and pathophysiology of sAML, and delves into past successful treatments as well as promising new treatments.
Topics: Biomarkers, Tumor; Combined Modality Therapy; Disease Management; Disease Susceptibility; Genetic Predisposition to Disease; Humans; Incidence; Leukemia, Myeloid, Acute; Prognosis; Treatment Outcome
PubMed: 32089222
DOI: 10.1016/j.hoc.2019.11.003 -
Cancer Control : Journal of the Moffitt... 2023The epidemiology of myeloid hematologic malignancies in Italy has been poorly investigated.
BACKGROUND
The epidemiology of myeloid hematologic malignancies in Italy has been poorly investigated.
METHODS
We used a validated database of 1974-2003 incident cases of hematologic malignancies among the resident population (all ages) of Sardinia, Italy, to describe the incidence of myeloid malignancies overall (N = 4389 cases) and by subtype. We investigated the time trend of acute myeloid leukemia (N = 1227 cases), chronic myeloid leukemia (N = 613 cases), and myelodysplastic syndrome (N = 1296 cases), and used Bayesian methods to explore their geographic spread, and Poisson regression analysis to estimate their association with environmental and socio-economic factors.
RESULTS
The annual standardized (world population) incidence rate (IR) of myeloid malignancies over the study period was 6.5 per 100,000 (95% CI 6.2-6.7). Myelodysplastic syndromes were the most prevalent subgroup (IR = 1.7, 95% CI 1.5-1.8). Incidence of all myeloid malignancies combined increased sharply during the study period with an annual percent change (APC) of 10.06% (95% CI 9.51-10.61), 19.77% for myelodysplastic syndromes (95% CI 19.63-19.91), and 3.18% (95% CI 2.99-3.37) for acute myeloid leukemia. Chronic myeloid leukemia did not show an upward trend. Apart from sporadic excesses in small rural communities and the major urban area, there was no evidence of spatial clustering. The risk of myeloid malignancies increased with increasing prevalence of sheep breeding.
CONCLUSIONS
Our results might prompt further research on the local genetic and environmental determinants of myeloid hematologic malignancies.
Topics: Humans; Animals; Sheep; Incidence; Bayes Theorem; Hematologic Neoplasms; Myelodysplastic Syndromes; Myeloproliferative Disorders; Leukemia, Myeloid, Acute; Leukemia, Myelogenous, Chronic, BCR-ABL Positive
PubMed: 37877513
DOI: 10.1177/10732748231202906 -
Blood Reviews May 2021While most clinicians recognize adult therapy-related leukemias following cytotoxic chemotherapy and radiation, environmental regulatory agencies evaluate exposure to... (Review)
Review
While most clinicians recognize adult therapy-related leukemias following cytotoxic chemotherapy and radiation, environmental regulatory agencies evaluate exposure to "safe levels" of leukemogenic compounds. Benzene represents the most notorious leukemogenic chemical. Used in the production of ubiquitous items such as plastics, lubricants, rubbers, dyes, and pesticides, benzene may be responsible for the higher risk of acute myeloid leukemia (AML) among automobile, janitorial, construction, and agricultural workers. It is possible that ambient benzene may contribute to many cases of "de novo" AML not arising out of germline predispositions. In this appraisal of the available literature, we evaluate and discuss the association between chronic, low-dose and ambient exposure to environmental benzene and the development of adult AML.
Topics: Adult; Benzene; Environmental Exposure; Humans; Leukemia, Myeloid, Acute; Occupational Exposure; Risk Factors
PubMed: 32771228
DOI: 10.1016/j.blre.2020.100736 -
European Journal of Haematology Jun 2022
Topics: Humans; Intracranial Hemorrhages; Leukemia, Myeloid, Acute
PubMed: 35202486
DOI: 10.1111/ejh.13761 -
Future Oncology (London, England) Mar 2021Older acute myeloid leukemia patients usually experience a bleak outcome, especially those in the unfit group. For this unfit category, intensive chemotherapy and... (Review)
Review
Older acute myeloid leukemia patients usually experience a bleak outcome, especially those in the unfit group. For this unfit category, intensive chemotherapy and allogeneic stem cell transplantation are usually accompanied by higher early mortality, which results from higher risk genetic profiles and worse psychological and physiological conditions. The significant improvement in genetic technology recently has driven the appearance of several mutation-targeted therapies, such as FLT3, Bcl-2, IDH and Hedgehog pathway inhibitors and an anti-CD33 antibody-drug conjugate, which have changed enormously the therapeutic landscape of acute myeloid leukemia. This review describes the treatment dilemma of the unfit group and discusses the objective clinical data of each targeted drug and mechanisms of resistance, with a focus on combination strategies with fewer toxicities and abrogation of drug resistance.
Topics: Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Biomarkers, Tumor; Disease-Free Survival; Drug Resistance, Neoplasm; Geriatric Assessment; Humans; Karnofsky Performance Status; Leukemia, Myeloid, Acute; Molecular Targeted Therapy; Mutation; Progression-Free Survival
PubMed: 33522289
DOI: 10.2217/fon-2020-0615 -
International Journal of Molecular... Jul 2020Recently, whole exome sequencing for acute myeloid leukemia (AML) has been performed by a next-generation sequencer in several studies. It has been revealed that a few... (Review)
Review
Recently, whole exome sequencing for acute myeloid leukemia (AML) has been performed by a next-generation sequencer in several studies. It has been revealed that a few gene mutations are identified per AML patient. Some of these mutations are actionable mutations that affect the response to an approved targeted treatment that is available for off-label treatment or that is available in clinical trials. The era of precision medicine for AML has arrived, and it is extremely important to detect actionable mutations relevant to treatment decision-making. However, the percentage of actionable mutations found in AML is about 50% at present, and therapeutic development is also needed for AML patients without actionable mutations. In contrast, the newly approved drugs are less toxic than conventional intensive chemotherapy and can be combined with low-intensity treatments. These combination therapies can contribute to the improvement of prognosis, especially in elderly AML patients who account for more than half of all AML patients. Thus, the treatment strategy for leukemia is changing drastically and showing rapid progress. In this review, we present the latest information regarding the recent development of treatment for AML.
Topics: Animals; Antineoplastic Agents; Combined Modality Therapy; Drug Approval; Epigenesis, Genetic; Humans; Immunotherapy, Adoptive; Leukemia, Myeloid, Acute; Molecular Targeted Therapy; Mutation; Precision Medicine; Signal Transduction; Small Molecule Libraries
PubMed: 32698349
DOI: 10.3390/ijms21145114