After an acute myeloid leukemia (AML) diagnosis, figuring out your specific risk group will help determine what treatment route you take.
“Our goal is always to cure a patient with a disease like AML,” Dr. Raoul Tibes, Director of the Clinical Leukemia Program at NYU Langone Health tells SurvivorNet. But determining how to get to that cure and if it’s possible, he says, depends on how an individual’s particular case of AML is grouped.
“We group AMLs according to what we call cytogenetics and other molecular markers,” Dr. Tibes says.
Cytogenetics are loss or changes to the structure of chromosomes. Dr. Tibes says doctors will also look for genetic mutations on top of chromosomes, which could be indicators of risk.
“Based on all that information, we can group leukemias into the chromosome status, as well as mutations and genes. We take them together and then we have three or four different risk stratification groups,” he says. “That helps us decide which therapy we use.”
Some patients can be cured with chemotherapy alone, Dr. Tibes says, while others may require additional treatment like a stem-cell transplant. These treatment decisions will be based on the genetic and genomic information, and need to be made early on in the treatment process.
Patients who are not candidates for chemotherapy and stem-cell transplants — which happens often because AML patients tend to be older — may opt for something called lower-intensity treatments. In this setting, Dr. Tibes says, people are given treatment on an out-patient system, with the goal of preserving the patient’s quality of life.
There are several tests that need to be performed for a doctor to diagnose a patient with AML. After a diagnosis, the doctor will also identify the person’s “subgroup,” which helps determine the best course of treatment to take.