Special Issue "Acute Myeloid Leukemia (AML): Novel Therapeutic Approaches"

Dear Colleagues,

Many improvements have been achieved in the last few years in the understanding of the biologic mechanism of Acute Myeloid Leukemia (AML) and, for the first time in decades, several new drugs have been introduced as well.

As a consequence, the WHO classification of AML and the prognostic risk scores such as European Leukemia Net (ELN) have become significantly more complicated in their last edition, if compared to the first attempts of classification and prognostication in AML.

Therefore, for newly diagnosed patients, a great deal of information should be obtained before starting induction therapy, in order to maximize the efficacy. For instance, non-high-risk patients with CD33 expression may benefit from CD33-targeting antibodies, patients with mutated FLT3 may benefit from TKI, patients with secondary AML or therapy related AML may benefit from CPX-351 instead of conventional chemotherapy,, etc. Furthermore, minimal residual disease assessment by flow cytometry, RT-PCR, NGS may allow to refine the definition of response to treatment, thus helping to allocate patients to stem cell transplantation consolidation more efficiently.

However, despite all those advances, several issues remain to be resolved. The treatment of elderly and unfit patients has seen a significant improvement with the introduction of the BCL-2 inhibitor venetoclax in addition to hypomethylating therapy, but median survival is still disappointing and cure is still unlikely in this setting. Furthermore, high risk disease is still an open issue, with an unsatisfying outcome even among younger, fit patients.

From a more biological point of view, many patients are still classified among the heterogeneous “AML not otherwise specified” group and this is often reflected in the risk assessment, with a big proportion of patients still considered at “intermediate” risk.

Undoubtedly, there is still need for improvement and several trial testing new molecules to be included in more conventional backbones are ongoing, and a more precise understanding of the biology of the disease achieved through ongoing biological studies will help to improve the classification at diagnosis.

In this Special Issue, we solicit clinical studies with emphasis on: new drugs for AML treatment, with particular focus on elderly unfit patient population; novel insights on genomic landscape of AML that may improve the risk assessment at diagnosis and on novel approach to AML treatment, including minimal residual disease assessment-driven treatment and novel strategy aimed to improve the application of allogeneic stem cell transplantation.

Both original research papers and comprehensive review papers are welcome.

Dr. Fabio Guolo
Guest Editor

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• acute myeloid leukemia
• prognosis
• classification
• risk score
• new drugs
• minimal residual disease
• NGS
• genomic landscape
• stem cell transplantation
• immunotherapy
• precision medicine