How I Treat AML in 2023 Incorporating the Updated Classifications and Guidelines

Abstract

The European LeukemiaNet (ELN) recently revised both the clinical (2022) and measurable residual disease (MRD) testing (2021) guidelines for acute myeloid leukemia (AML). Updated World Health Organization (WHO) and an International Consensus Classification (ICC) for myeloid neoplasms were also published in 2022. Together, these documents update the classification, risk stratification, prognostication, monitoring recommendations, and response assessment for patients with AML. Increased appreciation of the genetic drivers of AML over the past decade and our increasingly sophisticated understanding of AML biology have been translated into novel therapies and more complex clinical treatment guidelines. Somatic genetic abnormalities and germline predispositions now define and guide treatment and counseling for subtypes of this hematologic malignancy. In this paper, we discuss how we approach AML in daily clinical practice taking into consideration these recent updates in the context of new treatments and discoveries over the past decade.