[Acute myeloid leukemia therapy in the era of comprehensive genomic profiling]

Acute myeloid leukemia (AML) is associated with various genetic abnormalities in its development and progression, which also affect treatment response and prognosis. The advent of gene panel testing is expected to clarify the involvement of these genetic mutations, which will provide useful information for treatment decision-making and prediction of prognosis in clinical practice. Some therapies have already been developed for actionable mutations: quizartinib for FLT3-ITD mutations is available for newly diagnosed AML, and ivosidenib for IDH1 mutations is awaiting approval. Knowledge of baseline genetic characteristics also allows for diagnosis according to the ICC 2022 and 5th edition of the WHO Classification, as well as risk stratification by the ELN2022 risk classification for patients receiving intensive chemotherapy and ELN2024 risk classification for patients receiving reduced-intensity chemotherapy. CPX-351, a liposomal formulation of cytarabine and daunorubicin, has also shown efficacy in patients with MDS-related gene mutations. Decisions on allogeneic transplantation and accessibility of investigational drugs are also expected. Detailed diagnosis and prognosis prediction based on the profile of genetic abnormalities should enable precision medicine.