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Review
. 2017 Jan 26;129(4):424-447.
doi: 10.1182/blood-2016-08-733196. Epub 2016 Nov 28.

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Hartmut Döhner  1 , Elihu Estey  2 , David Grimwade  3 , Sergio Amadori  4 , Frederick R Appelbaum  2 , Thomas Büchner  5 , Hervé Dombret  6 , Benjamin L Ebert  7 , Pierre Fenaux  8 , Richard A Larson  9 , Ross L Levine  10 , Francesco Lo-Coco  4 , Tomoki Naoe  11 , Dietger Niederwieser  12 , Gert J Ossenkoppele  13 , Miguel Sanz  14 , Jorge Sierra  15 , Martin S Tallman  10 , Hwei-Fang Tien  16 , Andrew H Wei  17   18 , Bob Löwenberg  19 , Clara D Bloomfield  20
Affiliations
Review

Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel

Hartmut Döhner et al. Blood. .

Abstract

The first edition of the European LeukemiaNet (ELN) recommendations for diagnosis and management of acute myeloid leukemia (AML) in adults, published in 2010, has found broad acceptance by physicians and investigators caring for patients with AML. Recent advances, for example, in the discovery of the genomic landscape of the disease, in the development of assays for genetic testing and for detecting minimal residual disease (MRD), as well as in the development of novel antileukemic agents, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. The recommendations include a revised version of the ELN genetic categories, a proposal for a response category based on MRD status, and criteria for progressive disease.

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Figures

Figure 1.
Figure 1.
Molecular classes of AML and concurrent gene mutations in adult patients up to the age of ∼65 years. Class definition is based on the study by Papaemmanuil et al. For each AML class denoted in the pie chart, frequent co-occurring mutations are shown in the respective boxes. Data on the frequency of genetic lesions are compiled from the databases of the British Medical Research Council (MRC), the German-Austrian AML Study Group (AMLSG), and from selected studies.,,, a indicates cohesin genes including RAD21 (∼10%), SMC1A (∼5%), and SMC3 (∼5%); b, inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11; c, inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2,MECOM(EVI1); and d, TP53 mutations are found in ∼45%, and complex karyotypes in ∼70% of this class. The structure of the pie chart is adapted from Grimwade et al, generated by Adam Ivey (King’s College London, London, United Kingdom).
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