Acute Myeloid Leukemia: NCCN 2025 Guidance
AML is an aggressive adult leukemia classified by genetics; intensive or lower-intensity therapy is chosen by fitness and risk.
Overview
Acute myeloid leukemia (AML) is a fast-growing blood cancer in adults arising from immature myeloid cells. A related subtype, acute promyelocytic leukemia, is treated distinctly.
Diagnosis combines blood counts, bone marrow examination, and genetic testing to define the disease.
Diagnosis And Risk
Bone marrow aspirate and biopsy confirm the presence of blasts. Cytogenetic and molecular studies sort patients into favorable, intermediate, and adverse risk groups.
This risk assessment, along with age and fitness, shapes the treatment plan. Measurable residual disease testing refines monitoring.
Treatment
Fit patients typically receive intensive induction with cytarabine and an anthracycline. Some receive a targeted antibody based on CD33 status.
Patients who are older or less fit may use lower-intensity regimens combining a hypomethylating agent with a targeted drug. Allogeneic transplant is considered for high-risk disease.
Relapsed Disease
Relapse calls for repeat genomic profiling to find actionable changes. Enrollment in clinical trials and, when suitable, stem cell transplant are key considerations.
