Next-Generation Sequencing and Detection of Minimal Residual Disease in Acute Myeloid Leukemia: Ready for Clinical Practice?

Acute myeloid leukemia (AML) represents a heterogeneous disease, both with respect to molecular pathogenesis and clinical outcome. Although dose-intensive chemotherapy and allogeneic stem cell transplantation have improved outcomes in AML, there remains significant heterogeneity in clinical outcome such that approximately 20% of patients are cured with existing therapies, 20% have therapy-refractory disease from the time of diagnosis, and 50% relapse and die from refractory disease after an initial response to leukemia therapy.^1-4 The challenge is how to best determine prognosis and identify which patients will have a substantive chance of cure, and which patients will likely relapse or present with refractory disease. Current standard of care uses clinical, cytogenetic, and molecular factors for risk stratification; however, there remains a pressing need for better approaches to prognostication in AML.