Less utilized prognostic markers in acute myeloid leukemia

Abstract

Acute myeloid leukemia (AML) results from the over-proliferation of progenitor cells of the myeloid lineage in the bone marrow.  It is a heterogeneous disease that is aggressive and difficult to treat.  AML diagnosis is based on clinical as well as laboratory investigations.  Risk stratification is important to direct therapeutic strategy.  Current guidelines for risk stratification are dependent on identification of genetic aberrations particularly chromosome translocations and gene mutations.  Though these are observed in the majority of patients, the best treatment regimen remains elusive.  AML blasts are assumed to have transformed from a normal counterpart and maintains many normal regulatory functions.  Early features such as stem cell properties has long been proven to be linked to early relapse in AML.  The presence of these cells may be measured in in vitro cultures which are also suitable media to determine its responsiveness to treatment, replicative of its interaction with the microenvironment.   These potential prognostic markers are well studied but are currently not considered in patient management.