Disease-Related Factors Impacting Acute Myeloid Leukemia (AML) Prognosis1,2

AML is a heterogeneic disease associated with varied abnormal cytogenetics, specific gene mutations, and subtypes that all affect patient prognosis.1

Three key disease-related factors that affect the prognosis in patients with AML are abnormal cytogenetics, genetic mutations, and the type of AML.1-5

Abnormal cytogenetics: deletions, translocations, rearrangements, duplications.1

  • Cytogenetic abnormalities are among the most important disease-related prognostic factors1
  • An abnormal karyotype is observed in approximately 60% of patients6

Genetic Mutations: FLT3, IDH1/2, NPM1, ASXL1, TP53, c-KIT, CEBPA, DNMT3A, MLL, RUNX12,4

  • A study was performed using whole genome sequencing of 12 cases of normal karyotype and 12 cases of t(15;17)-positive AML to identify somatic, AML-associated mutations
    • On average, there were 440 somatic mutations in the entire genome, with an average of 10 mutations with translational consequences2

AML type5,7

  • De novo AML: no prior myelodysplastic syndromes (MDS), myeloproliferative disorders (MPD), or exposure to leukemogenic therapies or agents
  • Secondary AML: prior MDS/myeloproliferative neoplasms (MPN)
  • Therapy-related AML: prior chemotherapy or radiation exposure
  • Other leukemogenic exposure-related: long-term exposure to benzene or cigarette smoke

References: 1. Foran JM. New prognostic markers in acute myeloid leukemia: perspective from the clinic. Hematology Am Soc Hematol Educ Program. 2010;2010:47-55. 2. Welch JS, Ley TJ, Link DC, et al. The origin and evolution of mutations in acute myeloid leukemia. Cell. 2012;150(2):264-278. 3. Acute Myeloid Leukemia (AML) Subtypes and Prognostic Indicators. American Cancer Society website. https://www.cancer.org/cancer/acute-myeloid-leukemia/detection-diagnosis-staging/how-classified.html. Accessed April 22, 2021. 4. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Acute Myeloid Leukemia V.3.2021. © National Comprehensive Cancer Network, Inc. 2021. All rights reserved. Accessed April 22, 2021. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 5. Cheson BD, Bennett JM, Kopecky KJ, et al. Revised recommendations of the International Working Group for diagnosis, standardization of response criteria, treatment outcomes, and reporting standards for therapeutic trials in acute myeloid leukemia. J Clin Oncol. 2003;21(24):4642-4649. 6. Grimwade D, Hills RK. Independent prognostic factors for AML outcome. Hematology Am Soc Hematol Educ Program. 2009:385-395. 7. Risk Factors for Acute Myeloid Leukemia (AML). American Cancer Society website. https://www.cancer.org/cancer/acute-myeloid-leukemia/causes-risks-prevention/risk-factors.html. Accessed April 22, 2021.