Acute myeloid leukemia and prognosis in the era of molecular markers

Introduction. Acute myeloid leukemia is a malignant, clonal disease of a hematopoietic stem/progenitor cell, characterized by accumulation of acquired somatic genetic and epigenetic alterations. Acute myeloid leukemia is, basically, highly heterogeneous disease, so individual treatment approach is needed. With the use of high-throughput genome sequencing technologies, a full spectrum of recurrent gene mutations in acute myeloid leukemia has been discovered, which has also provided deeper insight into leukemogenesis and acute myeloid leukemia ontogeny. This review focuses on molecular markers with proven prognostic significance, which form, together with standard cytogenetics, basis for current acute myeloid leukemia risk stratification. Even in the era of molecular markers, standard prognostic factors (pre-treatment and postinduction factors) have a strong influence on the choice of postremission therapy. Conclusion. Evaluation of molecular markers and their impact on prognosis in acute myeloid leukemia should be interpreted in the context of complex gene interactions. Only comprehensive understanding of acute myeloid leukemia biology and integration of all prognostic markers enable us to timely plan risk adapted treatment.