Acute myeloid leukaemia Journal Article
| Authors: | Khwaja, A.; Bjorkholm, M.; Gale, R. E.; Levine, R. L.; Jordan, C. T.; Ehninger, G.; Bloomfield, C. D.; Estey, E.; Burnett, A.; Cornelissen, J. J.; Scheinberg, D. A.; Bouscary, D.; Linch, D. C. |
| Article Title: | Acute myeloid leukaemia |
| Abstract: | Acute myeloid leukaemia (AML) is a disorder characterized by a clonal proliferation derived from primitive haematopoietic stem cells or progenitor cells. Abnormal differentiation of myeloid cells results in a high level of immature malignant cells and fewer differentiated red blood cells, platelets and white blood cells. The disease occurs at all ages, but predominantly occurs in older people (>60 years of age). AML typically presents with a rapid onset of symptoms that are attributable to bone marrow failure and may be fatal within weeks or months when left untreated. The genomic landscape of AML has been determined and genetic instability is infrequent with a relatively small number of driver mutations. Mutations in genes involved in epigenetic regulation are common and are early events in leukaemogenesis. The subclassification of AML has been dependent on the morphology and cytogenetics of blood and bone marrow cells, but specific mutational analysis is now being incorporated. Improvements in treatment in younger patients over the past 35 years has largely been due to dose escalation and better supportive care. Allogeneic haematopoietic stem cell transplantation may be used to consolidate remission in those patients who are deemed to be at high risk of relapse. A plethora of new agents-including those targeted at specific biochemical pathways and immunotherapeutic approaches-are now in trial based on improved understanding of disease pathophysiology. These advances provide good grounds for optimism, although mortality remains high especially in older patients. © 2016 Macmillan Publishers Limited. All rights reserved. |
| Keywords: | cancer survival; gene mutation; clinical feature; cancer risk; nonhuman; patient selection; pathophysiology; drug megadose; cancer incidence; cell structure; cancer immunotherapy; cancer prevention; thrombocyte; bone marrow; cancer screening; cytogenetics; cell differentiation; mutational analysis; stem cell; chromosome aberration; epigenetics; cancer cell; leukemogenesis; acute myeloblastic leukemia; promyelocytic leukemia; genomics; allogeneic hematopoietic stem cell transplantation; erythrocyte; cancer epidemiology; bone marrow cell; hematopoietic stem cell; anthracycline; leukemia relapse; leukocyte; leukemia remission; dna methyltransferase 3a; randomized controlled trial (topic); bone marrow depression; phase 2 clinical trial (topic); phase 3 clinical trial (topic); phase 1 clinical trial (topic); cancer prognosis; human; priority journal; article |
| Journal Title: | Nature Reviews Disease Primers |
| Volume: | 2 |
| ISSN: | 2056-676X |
| Publisher: | Nature Publishing Group |
| Date Published: | 2016-03-10 |
| Start Page: | 16010 |
| Language: | English |
| DOI: | 10.1038/nrdp.2016.10 |
| PROVIDER: | scopus |
| PUBMED: | 27159408 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 February 2017 -- Source: Scopus |
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
-
776Levine -
499Scheinberg
Related MSK Work