Elucidating the risk factors and oncogene drivers of acute myeloid leukemia

Abstract

The hematopoietic system is critical for maintaining physiological homeostasis but is also implicated in various pathologies. The magnitude of hematopoietic responses to perturbations or diseases exhibits significant inter-individual variability, underscoring the need to identify predictors and determinants of blood responsiveness in humans. These reactions are shaped not only by genetic factors but also by epigenetic modifications and environmental effects. Elucidating baseline predictors of hematopoietic responses and their molecular underpinnings is of particular interest in acute myeloid leukemia (AML), given their potential to inform malignancy immunotherapy. Due to limited understanding of the cellular and molecular mechanisms driving diverse AML subtypes in pediatric and adult patients, coupled with an increasing prevalence of refractory or relapsed hematological malignancies, this review highlights underexplored prognostic biomarkers, their molecular mechanisms, and their potential clinical utility in optimizing therapeutic strategies for improved patient survival. It examines recent advances in AML research and vaccine development, focusing on efforts to address highly aggressive and rare AML subtypes driven by aberrantly activated transcription factors. The review also addresses clinical implications for overall survival and treatment response, as well as promising vaccine candidates. Additionally, it highlights newly identified mutations and high-risk molecular markers that could enhance risk stratification for early disease progression, identifying patients who may benefit from allogeneic stem cell transplantation or enrollment in clinical trials.

Keywords: Acute myeloid leukemia; Biomarkers; Cancer genetics; Fusion oncoprotein; Hematological cancer; Oncology; Risk factors; Vaccine.