Acute myeloid leukemia: 2023 update on diagnosis, risk-stratification and management.

Both an improved understanding of acute myeloid leukemia (AML) pathophysiology plus improvements in measurement technology have led to revamping the diagnostic, prognostic, and therapeutic landscape of AML. New classification systems integrating molecular insights, updated risk assessment, improved ability to measure low levels of disease as well as least ten recently approved therapies may promote better outcomes including cures in a larger fraction of AML patients. The diagnostic and therapeutic complexity makes the decision-making process ever more individualized and requires integration of patient goals of care, comorbidities and disease characteristics including the specific mutational profile of the patient. In this review we present recent advances in diagnosis, classification, risk stratification and treatment options for patients with newly diagnosed (ND) or relapsed and refractory (R/R) AML. Such advances are welcome, but the increased options also lead to many controversies concerning the optimal selection of the timing and combinatorial use of the new drugs and how best to leverage our burgeoning ability to measure a small number of potentially malignant myeloid cells. In this context, we will present our approach for AML management noting current limitations and potential future directions. This article is protected by copyright. All rights reserved.