How is Acute Myeloid Leukemia Staged and Classified?

Acute Myeloid Leukemia (AML) is a complex disease, with different subtypes based on unique genetic and chromosomal changes. Knowing your specific AML characteristics can help doctors tailor your treatment for the best possible outcome. This guide aims to simplify the latest AML classification systems, helping you understand your diagnosis and treatment options.

To classify AML, a bone marrow biopsy and testing of the cytogenetics of the leukemia cells called blasts are necessary. Since this type of cancer is not a solid tumor, other strategies have been developed to understand its severity and future outcomes. 

Why Should I Know My AML Classification?

Classifying your AML will allow you to discover more about the precise and personalized treatments available. Your healthcare team will use this detailed information to tailor your treatment plan, potentially improving outcomes.

Understanding the specific subtype of AML you have can make a significant difference in your treatment. The new classification systems enhance the precision of AML diagnosis, allowing for more personalized and effective care. Always discuss your specific diagnosis and treatment options with your healthcare team to ensure you receive the best possible care.

What are the Recent Updates in AML Classification?

The latest update from AML guidelines was published in November 2023, and reported two new guidelines that refined AML classification:

1. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumors (WHO-HAEM5)

2. The International Consensus Classification (ICC)

Both guidelines expand on the molecularly defined AML subtypes, enhancing the precision of AML diagnosis and treatment.

What are AML Types? 

As more research on AML emerges, specialists now have more ways of evaluating and categorizing AML. We now know that AML is not a single disease but rather a disease of many types. The different types of AML depend on:

• How developed the leukemia cells are at the time of diagnosis
• The kinds of proteins present on the surface of the leukemia cells
• How different the leukemia cells appear to be when compared to normal cells
• The type of genetic abnormality the leukemia cells present

Doctors use genetic testing to evaluate the chromosomes (long strands of DNA) in the leukemia cells. Additional genetic tests also allow doctors to identify specific mutations a patient with AML may have in their leukemia cells. Identifying these changes and abnormalities can help doctors recognize and treat specific subtypes of AML.

Early recognition of these different subtypes can be vital to providing targeted care and therapy. 

Genetic and Chromosomal Abnormalities in Acute Myeloid Leukemia (AML)

AML subtypes can be classified by specific genetic mutations and chromosomal changes. Understanding these mutations can help predict the disease's behavior and response to treatment. Some common genes affected in AML include:

• FLT3
• IDH1 and IDH2
• NPM1
• DNMT3A
• CEBPA
• TET2
• KIT

Many research projects aim to develop new drugs targeting these mutations, hoping to lead to more effective, personalized treatments.

Why is Acute Promyelocytic Leukemia (APL) Part of AML Classification?

APL is a subtype of AML with a specific genetic mutation: t(15;17). It has a good prognosis and is often treated with vitamin therapy.

FAQs

1. What is AML?

• AML is a type of blood cancer that starts in the bone marrow and spreads to the blood.

2. Why is genetic testing important in AML?

• Genetic testing helps identify the specific subtype of AML, guiding personalized treatment plans.

3. How do the new classifications improve treatment?

• They provide a more detailed understanding of AML subtypes, allowing for more targeted therapies.

4. What are common genetic mutations in AML?

• Some common mutations include FLT3, IDH1, IDH2, NPM1, DNMT3A, CEBPA, TET2, and KIT.

5. What is APL?

• APL is a subtype of AML characterized by the t(15;17) translocation, often treated with vitamin therapy.

By understanding your AML classification, you can better navigate your diagnosis and treatment options, ensuring you receive the most effective care tailored to your specific needs.

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Source: 

• Advances in Acute Myeloid Leukemia Classification: A Comparative Analysis of Who-HAEM4R, Who-HAEM5, and International Consensus Classification