title: Innovative strategies for adverse karyotype acute myeloid leukemia.
abstract: Adverse karyotype acute myeloid leukemia is a disease particularly of older patients, but also observed in younger patients. Despite all efforts, standard chemotherapy is still generally applied in fit patients, as already for decades, and for nearly all different subtypes of acute myeloid leukemia. Lack of more specifically targeted therapy and the often older age of the patients are complicating treatment, and in the subgroup of patients achieving a complete remission, the strikingly high frequency of relapse is a characteristic of this disease. This review aims to give an overview of current treatment approaches as well as emerging therapies.
  
  
  
  Currently, the approach of a targeted therapy specific to the genetic and/or epigenetic aberrations detected in the individual patient is still not possible, and a 'one treatment fits all' course of action is still used, with allografting as curative consolidation. However, first immunotherapeutic approaches are emerging as treatment options and first phase 1 and 2 studies are described.
  
  
  
  Treatment of acute myeloid leukemia with adverse karyotype is still not individualized, most treatment options currently not being curative. This can change in the near future, but recent findings will have to be implemented into larger phase 3 studies before being standard of care.
authors.affiliation: aService and Central Laboratory of Hematology, CHUV, University Hospital of Lausanne, Lausanne, Switzerland bDivision of Hematology, Oncology and Stem Cell Transplantation, Department of Internal Medicine, Faculty of Medicine, University of Freiburg Medical Center cFaculty of Biology, University of Freiburg dDKTK, German Consortium for Translational Cancer Research, Freiburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Blum
authors.forename: Gabriele
authors.initials: G
authors.lastname: Greve
authors.forename: Michael
authors.initials: M
authors.lastname: Lübbert
mesh_terms: D059786:Abnormal Karyotype; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D044127:Epigenesis, Genetic / Q000187:drug effects; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics* / Q000401:mortality / Q000628:therapy*; D058990:Molecular Targeted Therapy; D009154:Mutation; D012074:Remission Induction; D059039:Standard of Care; D016896:Treatment Outcome