[Molecular and cytogenetic prognostic factors in acute myeloid leukemia (AML)]

Acute myeloid leukemia (AML) constitutes a group of diseases that are very heterogeneous with regard to clinical course, response to therapy as well as cytogenetic aberrations and gene mutations. Such lesions are of prognostic value. Patients with t(8;21), inv(16)/t(16;16) or t(15;17) have a favorable prognosis. Patients with normal karyotype and aberrations +6, +8 –Y, t(9;11) and del(12p) are classified in the group of intermediate prognosis. In the case of patients with complex karyotype or with the aberrations inv(3)/t(3;3), t(6;9), –5, –7, del(5q), del(7q) and 11q23 rearrangements, the prognosis is poor. Unfavorable molecular factors include C-MYC amplification, MLL amplification and rearrangement, FLT3-ITD, WT1 mutation and overexpression of BAALC, ERG or MN1. The changes in miRNA expression may also be important for AML prognosis. That is why the cases with normal karyotype (CN-AML) and cases with complex aberrations remain to be better characterized at the genetic level. Array technology enables the analysis of genomic DNA and gene expression. This approach may be used in the search for new prognostic and predictive markers in AML.