Leucemias agudas

Abstract

Acute leukemias are neoplastic proliferations of clonal immature hematopoietic cells (blasts) whose progressive accumulation in the bone marrow (BM) is accompanied by a decrease in the rest of the series. The natural evolution is a rapid progression with symptoms of spinal cord failure and infiltration of other tissues. There are two main groups according to the cell type that causes the proliferation: acute lymphoblastic leukemia if the neoplastic cell is of lymphoid origin or acute myeloid leukemia if the neoplastic cell is of myeloid origin. This update will focus on the latter, which are more common as individuals age. Diagnosis is based on a bone marrow aspiration with the presence of 20% blasts or a lower percentage in the presence of a defining genetic alteration. Therefore, phenotypic, genetic, and molecular characterization is essential for determining prognosis and guiding treatment with both target agents and through minimal residual disease (MRD). In young patients who are candidates for intensive treatment, induction polychemotherapy regimens are used followed by allogeneic or autologous transplantation guided by prognostic risk or MRD. The inclusion of older adult patients in clinical trials and the use of targeted therapies are now common.