Clinical potential of introducing next-generation sequencing in patients at relapse of acute myeloid leukemia.

Flach, Johanna; Shumilov, Evgenii; Wiedemann, Gertrud; Porret, Naomi; Shakhanova, Inna; Bürki, Susanne; Legros, Myriam; Joncourt, Raphael; Pabst, Thomas; Bacher, Ulrike (2020). Clinical potential of introducing next-generation sequencing in patients at relapse of acute myeloid leukemia. Hematological oncology, 38(4), pp. 425-431. Wiley 10.1002/hon.2739

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Relapse of acute myeloid leukemia (AML) remains a major determinant of outcome. A number of molecularly directed treatment options have recently emerged making comprehensive diagnostics an important pillar of clinical decision making at relapse. Acknowledging the high degree of individual genetic variability at AML relapse, next-generation sequencing (NGS) has opened the opportunity for assessing the unique clonal hierarchy of individual AML patients. Knowledge on the genetic makeup of AML is reflected in patient customized treatment strategies thereby providing improved outcomes. For example, the emergence of druggable mutations at relapse enable the use of novel targeted therapies, including FLT3 inhibitors or the recently approved IDH1/2 inhibitors ivosidenib and enasidenib, respectively. Consequently, some patients may undergo novel bridging approaches for reinduction before allogeneic stem cell transplantation, or the identification of an adverse prognostic marker may initiate early donor search. In this review, we summarize the current knowledge of NGS in identifying clonal stability, clonal evolution, and clonal devolution in the context of AML relapse. In light of recent improvements in AML treatment options, NGS-based molecular diagnostics emerges as the basis for molecularly directed treatment decisions in patients at relapse.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Wiedemann, Gertrud; Porret, Naomi; Bürki, Susanne; Joncourt, Raphael; Pabst Müller, Thomas Niklaus and Bacher, Vera Ulrike

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1099-1069

Publisher:

Wiley

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

15 Jun 2020 08:51

Last Modified:

24 Oct 2020 01:32

Publisher DOI:

10.1002/hon.2739

PubMed ID:

32306411

Uncontrolled Keywords:

acute myeloid leukemia (AML) minimal residual disease (MRD) next-generation sequencing (NGS) relapse

BORIS DOI:

10.7892/boris.144475

URI:

https://boris.unibe.ch/id/eprint/144475

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