Pharmacogenomics in Acute Myeloid Leukemia

Acute myeloid leukemia (AML) is a cancer of the myeloid line of blood cells. In AML, the bone marrow makes many immature cells called blasts, which do not mature and cannot fight infections. AML is a heterogeneous neoplasm with several pathological, genetic, and molecular subtypes. Combinations of various doses and schedules of drugs have been the majority of treatment for all types of AMLs in adult patients. However, not all patients have the same response to these treatments, some of which are adverse responses that are potentially life threatening. Because interindividual responses to AML medications can vary considerably, the potential for genetic contributions to variable drug responses is significant. The pharmacogenomics approach tries to find prognostic and predictive biomarkers permitting to identify patients who could benefit from a particular treatment or those exhibiting higher risks of toxicity. Pharmacogenomics is a rapidly improving science with the potential to revolutionize drug discovery/development and offers one possibility for rationalizing therapy/dose selection. It combines many different fields such as genetics, genomics, molecular biology, pharmacology, pharmaceutics, and population biology. This chapter focuses on treatment of AML, genetic and clinical prognostic markers, and recent advances in the field of pharmacogenomics in AML.