Acute myeloid leukemia (AML) was the first cancer to have its oncogene sequenced, determined in 2009 by the University of Washington research group. Candidate mutation analysis was performed, resulting in the identification of more than 40 known AML-associated mutations, some of which, such as FLT3 or IDH1/IDH2, may become targets for molecularly targeted therapies. the first recurrent human chromosomal translocation, t(8;21), was first described by Rowley in Chicago in 1973. Subsequent observations that more than half of the patients had karyotypic chromosomal abnormalities and the importance of these prognoses led the WHO to incorporate the underlying genetic classification of AML into the 2001 and 2008 revised tumor types, which builds on the joint French-US-UK classification of leukemia morphology first proposed in 1976. Although the treatment of ALL has improved significantly since the 1960s, the clinical prognosis of AML has only improved somewhat since the early 1970s. 1973 Yates et al. have demonstrated the efficacy of 7 days of continuous intravenous cytarabine and 3-day doses of erythromycin. Despite many efforts to improve this therapy, such as adding a third drug or adjusting drug doses and dosing times, the same therapy with minor modifications remains the standard of care for previously untreated patients with AML (other than APL) more than 40 years later. In some studies, desmethoxyzlotoxin instead of zlotoxin resulted in higher rates of complete remission, duration of response, or overall survival in patients younger than 60 y. In 1990, desmethoxyzlotoxin was approved by the FDA for AML, the only drug approved for AML in the United States in the last 25 years. Gitumumab was approved in 2000, but was withdrawn in 2010 (in 2013, decitabine was approved in Europe for use in elderly AML patients). Two randomized studies showed that doubling the standard zolpidem dose significantly improved complete remission rates and overall survival. A recent pooled analysis showed that both high-dose and standard-dose decitabine resulted in 5-year survival rates of 40 to 50 percent in patients younger than 60 years. A landmark paper published in 1994 changed the approach to post-remission consolidation therapy in young AML patients worldwide, with AML patients in remission receiving consolidation therapy followed by 1/3 of augmentin therapy as a continuous infusion for 5 days at 100 mg/m2 per day or 400
mg/m2, or 3,000 mg/m23 hours of infusion every 12 hours on days 1, 3, and 5. At a median follow-up of more than 4 years, the probability of maintaining complete remission in adult patients younger than 61 years was similar to that of the low-dose administration regimen (24%
and 29%), while the high-dose regimen was higher (44%). However, high-dose cytarabine was not effective in elderly patients. In 1979, a study by Thomas et al. sparked interest in allogeneic stem cell transplantation in patients in first complete remission. thomas et al. performed transplants in 19 patients with AML in first remission, with a mean age of 22 years, and an estimated 63% of patients were alive after 3 years. Since this study, many comparative studies have been conducted comparing the mixed prognosis of allograft therapy and other post-remission consolidation therapies for AML. A combined analysis comparing allogeneic stem cell transplantation with other post-remission consolidation therapies in AML patients in first remission, published on the 24th, leads to the conclusion that allogeneic stem cell transplantation has significantly better relapse-free survival and overall survival in patients with intermediate and high-risk AML, but is not effective in patients in safety. For elderly AML patients or other patients who may not benefit from or tolerate intensive therapy due to pathological conditions, their average survival is only a few months. Although low doses of cytarabine may increase survival by several months compared to maintenance therapy, new therapies are needed for these patients. the FDA-approved hypomethy modulating drugs azacitidine and decitabine for myelodysplastic syndromes have activity in AML. Many targeted therapies are currently being studied in clinical trials.