Recent Advances in Acute Myeloid Leukemia

Our expanding knowledge of acute myeloid leukemia (AML) over the last four decades has resulted in major advances in the understanding and classification of this disease. What we consider as acute myeloid leukemia is now known to represent a number of distinct, but related diseases, some of which require unique therapeutic approaches. The World Health Organization (WHO) classification of AML attempts to incorporate some features of traditional AML classification (particularly the FrenchAmerican-British Cooperative Group Classification, or FAB), while also recognizing the significance of cytogenetic changes, the presence of multilineage dysplasia and prior therapy. The WHO classification of AML include major categories of AML with recurring cytogenetic abnormalities, AML with multilineage dysplasia, therapy related AML and myelodysplasia, and AML, not otherwise categorized. While only four recurring cytogenetic abnormalities are currently in the classification, hopefully this category will be expanded in future editions. The WHO classification, which also includes other hematopoietic tumors, is now widely accepted for pathologic diagnosis, and thus represents a major advance in AML classification. Despite this, the transition from the FAB classification to the WHO system for many pathologists and hematologists is a difficult one.