title: Acute myeloid leukaemia.
abstract: Acute myeloid leukaemia (AML) is a disorder characterized by a clonal proliferation derived from primitive haematopoietic stem cells or progenitor cells. Abnormal differentiation of myeloid cells results in a high level of immature malignant cells and fewer differentiated red blood cells, platelets and white blood cells. The disease occurs at all ages, but predominantly occurs in older people (>60 years of age). AML typically presents with a rapid onset of symptoms that are attributable to bone marrow failure and may be fatal within weeks or months when left untreated. The genomic landscape of AML has been determined and genetic instability is infrequent with a relatively small number of driver mutations. Mutations in genes involved in epigenetic regulation are common and are early events in leukaemogenesis. The subclassification of AML has been dependent on the morphology and cytogenetics of blood and bone marrow cells, but specific mutational analysis is now being incorporated. Improvements in treatment in younger patients over the past 35 years has largely been due to dose escalation and better supportive care. Allogeneic haematopoietic stem cell transplantation may be used to consolidate remission in those patients who are deemed to be at high risk of relapse. A plethora of new agents - including those targeted at specific biochemical pathways and immunotherapeutic approaches - are now in trial based on improved understanding of disease pathophysiology. These advances provide good grounds for optimism, although mortality remains high especially in older patients.
authors.affiliation: Department of Haematology, University College London, UCL Cancer Institute, 72 Huntley Street, London WC1E 6DD, UK.
authors.forename: Asim
authors.initials: A
authors.lastname: Khwaja
authors.affiliation: Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Bjorkholm
authors.affiliation: Department of Haematology, University College London, UCL Cancer Institute, 72 Huntley Street, London WC1E 6DD, UK.
authors.forename: Rosemary E
authors.initials: RE
authors.lastname: Gale
authors.affiliation: Human Oncology and Pathogenesis Program, Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: Ross L
authors.initials: RL
authors.lastname: Levine
authors.affiliation: Division of Hematology, University of Colorado Denver, Denver, Colorado, USA.
authors.forename: Craig T
authors.initials: CT
authors.lastname: Jordan
authors.affiliation: Department of Internal Medicine, Technical University Dresden, Dresden, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.affiliation: Comprehensive Cancer Center, Ohio State University, Columbus, Ohio, USA.
authors.forename: Clara D
authors.initials: CD
authors.lastname: Bloomfield
authors.affiliation: Division of Hematology, University of Washington and Clinical Research Division Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
authors.forename: Eli
authors.initials: E
authors.lastname: Estey
authors.affiliation: CTI Life Sciences Ltd., Uxbridge, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Burnett
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Cornelissen
authors.affiliation: Molecular Pharmacology Program, Experimental Therapeutics Center, Leukemia Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Scheinberg
authors.affiliation: Institut Cochin, Département Développement Reproduction Cancer, CNRS UMR8104, INSERM U1016, Paris, France.|Service d'Hématologie, Hôpital Cochin, AP-HP, Paris, France.|Université Paris Descartes, Faculté de Médecine Sorbonne Paris Cité, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Bouscary
authors.affiliation: Department of Haematology, University College London, UCL Cancer Institute, 72 Huntley Street, London WC1E 6DD, UK.
authors.forename: David C
authors.initials: DC
authors.lastname: Linch
mesh_terms: D016026:Bone Marrow Transplantation / Q000401:mortality / Q000592:standards; D004358:Drug Therapy / Q000379:methods; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D009154:Mutation / Q000235:genetics*; D009190:Myelodysplastic Syndromes / Q000150:complications; D012008:Recurrence; D012074:Remission Induction / Q000379:methods; D012307:Risk Factors