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From marrow blasts to molecular risk — building a treatment plan that fits the disease and the patient
Acute myeloid leukemia (AML) is a clonal malignancy of immature myeloid cells that accumulates in the bone marrow and impairs normal blood production. Diagnosis requires at least 20% blasts in the marrow or blood in most settings, together with flow cytometric, cytogenetic and molecular characterisation. Treatment is risk-adapted and begins with induction, followed by consolidation and, for selected patients, allogeneic transplant.
Haematology & Haemato-Oncology
Authored and reviewed by Dr. Sachita Baniya (MBBS, FCPS (Clinical Haematology), NMC 20158). Evidence-based, no fabricated outcomes.
Acute myeloid leukemia (AML) is a clonal malignancy of immature myeloid cells that accumulates in the bone marrow and impairs normal blood production. Diagnosis requires at least 20% blasts in the marrow or blood in most settings, together with flow cytometric, cytogenetic and molecular characterisation. Treatment is risk-adapted and begins with induction, followed by consolidation and, for selected patients, allogeneic transplant.
Reviewed by Dr. Sachita Baniya, MBBS, FCPS — Consultant Haemato-Oncologist & Clinical Hematologist (NMC 20158). For evaluation, contact the respective hospital or cancer centre — Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital Kathmandu, or Advanced Care Hospital.
AML is suspected when cytopenias are accompanied by circulating blasts or marrow failure. Bone marrow aspiration and biopsy, flow cytometric immunophenotyping, cytogenetics, FISH and molecular panels establish the lineage, maturation and genetic subtype. The WHO and ICC classifications incorporate defining translocations, gene mutations and myelodysplasia-related changes, because these features affect prognosis and treatment.
Fit patients usually receive intensive induction chemotherapy, with the aim of morphological remission and measurable residual disease (MRD) clearance. Consolidation may involve further chemotherapy or allogeneic transplant, depending on genetic risk, MRD and patient fitness. Older or unfit patients may receive hypomethylating agents with venetoclax or other lower-intensity regimens. Targeted agents are selected by mutation, and supportive care is planned from the first cycle.
Guidelines referenced:
WHO Classification of Tumours of Haematopoietic and Lymphoid TissuesEuropean LeukemiaNet recommendations for diagnosis and management of AMLNCCN Guidelines — Acute Myeloid LeukemiaContent on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.