How molecular testing guides treatment in AML

Gail Roboz, MD from Weill Medical College of Cornell University, New York, NY gives an overview of her talk on ‘How I use molecular genetics to guide treatment in AML’ held at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), in Glasgow, Scotland. In the US, the standard of care in terms of molecular genetics for acute myeloid leukemia (AML) is to order FLT3, NPM1 and CEBP tests. According to Dr Roboz, it is now becoming more common to order up to 200 gene panels. In terms of treatment, FLT3 guides treatment due to the availability of FLT3 inhibitors, and for younger patients, there is a bias for allogeneic stem cell transplantation according to Dr Roboz. For isolated NPM1 mutations, often the decision is not go forward with stem cell transplantation, which is controversial according to Dr Roboz. Patients with CEBP double mutations are often not offered allogeneic stem cell transplantation in first remission. Dr Roboz further discusses IDH mutations.