Dr. Carraway on Predisposition to Acute Myeloid Leukemia

Hetty Carraway, MD, oncologist, Cleveland Clinic, discusses predisposition to acute myeloid leukemia (AML).

Research has been done on the presence of mutations in patients who do not possess a hematologic malignancy. This research led to understanding of the presence of mutations and clonal hematopoiesis of indeterminate potential. That work was seminal in leading other research groups to question the development of AML in larger cohorts of patients, says Carrway.

In that research, as many as 150,000 patients who had leukemia were selected. These patients were retrospectively examined via serial samples of blood as far as 10 years prior to their diagnosis to see what happened following the detection of mutations. In that time span, researchers were able to identify differences in the presence of mutations and the variant allele frequency in specific genes that were associated with a higher risk of progression to AML compared to those who did not have those mutations, states Carrway. That work has enabled physicians to think more deeply about changing that trajectory for patients, adds Carrway.