Acute myeloid leukemia

Background. Acutemyeloid leukemia (AML) is the most common form of acute leukemia in adults, particularly in elderly patients over 60 years of age. Considering the increasing life expectancy of the general population, the incidence of AML will increase in the future. Objective. Condensed overview of the current state of the art of standards in diagnosis and treatment of AML. Material and method. Literature search and summary of results. Results. Patients up to a biological age of 75 years can be treated with a curative approach using intensive chemotherapy with or without allogeneic stem cell transplantation. Prognosis and treatment intensity depend on age as well as cytogenetic and molecular changes of AML blasts. Cytogenetic and molecularmethods provide a classification into genotype-specific subtypes, which allows a prognostic stratification. Patients with severe comorbidities or higher age can be treated in an outpatient setting using a non-intensive cytoreductive approach with the goal to prolong survival. The rare form of acute promyelocytic leukemia (APL) has a considerably better prognosis with high healing rates in all age groups. The occurrence of sometimes life-threatening bleeding complications at initial diagnosis of APL can be controlled by rapid administration of alltrans retinoic acid (ATRA). Patients with a nucleophosmin-1 (NPM1) mutationor specific translocations can bemonitored by PCR-based techniques (minimal residual disease. MRD). Subgroup-specific targeted therapies, such as tyrosine kinase inhibitors and antibodies are currently in clinical development. Conclusion. Growing insights and understanding of disease biology and underlying genetic changes form the basis for more individualized prognostication and treatment and will improve the prognosis of AML patients in the future.