Cytogenetic abnormalities are long been useful in guiding treatment for acute myeloid leukemia (AML). One of the crucial questions in the treatment algorithm is whether or not an allogeneic stem-cell transplant is an option. Transplantation can be a curative treatment for AML, but it carries risks, including transplant related mortality and morbidity. Currently, it is usually considered for AML when the cytogenetic abnormalities foretell a high risk for relapse after chemotherapy and avoided when there is a cytogenetic pattern that is associated with a relatively favorable prognosis.
New details of differences among patients with cytogenetically normal AML, which appear to affect both clinical and treatment outcome, are described in 2 papers published in the May 1 issue of the New England Journal of Medicine. One paper describes new gene mutations, and the other outlines microarray microRNA expression profiles. Both studies demonstrate the complex molecular heterogeneity of AML and may add to the accumulating knowledge about the way genetic disruptions in AML can affect prognosis.
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