Acute Myeloid Leukemia: Prognosis, Survival, and Key Cytogenetic and Molecular Factors Affecting AML Life Expectancy

Acute myeloid leukemia (AML) is a complex hematological disease characterized by the clonal proliferation of immature myeloid precursors in the bone marrow. Despite advancements in treatment, the acute myeloid leukemia prognosis and survival of patients with AML vary significantly, influenced by a range of cytogenetic and molecular factors. These factors not only assist in risk stratification but also guide therapeutic decisions and predict treatment response.

Cytogenetic and Molecular Factors in AML

Cytogenetic factors have long been the foundation for risk stratification in AML. Anomalies such as t(15;17), t(8;21), and inv(16) are associated with a favorable prognosis, while others like -5, -7, and complex alterations indicate an adverse prognosis. A comprehensive study of 5,876 patients underscored the importance of these anomalies in predicting outcomes [1].

Regarding molecular factors, mutations in genes such as DNMT3A, RUNX1, and TP53 have proven to be significant predictors of shorter overall survival, especially in patients under 60 years of age [2]. The NPM1 mutation in the absence of FLT3-ITD and biallelic mutations of CEBPA are associated with a more favorable prognosis, regardless of the patient's age [3].

The use of advanced technologies such as next-generation sequencing has allowed for a deeper understanding of molecular aberrations in AML, facilitating the development of targeted therapies. Inhibitors of FLT3 and IDH, among others, have emerged as promising therapeutic options [4].

Conclusions

The integration of cytogenetic and molecular factors in the evaluation of acute myeloid leukemia prognosis is essential for improving AML life expectancy for patients. The precise identification of these factors enables more effective risk stratification and the personalization of therapeutic strategies. As research advances, new opportunities are likely to arise to enhance acute leukemia survival through the incorporation of targeted therapies and personalized approaches.

Referencias

• [1] Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials.
• [2] Spectrum and prognostic relevance of driver gene mutations in acute myeloid leukemia.
• [3] Molecular, clinical, and therapeutic determinants of outcome in NPM1-mutated AML.
• [4] Updates on targeted therapies for acute myeloid leukaemia.

Created 13/1/2025