Review Articles
Vol. 18 No. 1 (2026): Mediterranean Journal of Hematology and Infectious Diseases
ACUTE MYELOİD LEUKEMİA, MYELODYSPLASİA-RELATED: BEYOND CLASSİFİCATİON—TOWARD PRECİSİON DECİSİON-MAKİNG
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: September 1, 2026
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Acute myeloid leukemia, myelodysplasia-related (AML-MR), represents a genetically defined and clinically heterogeneous entity characterized by myelodysplasia-related gene (MRG) mutations, specific cytogenetic abnormalities, and frequently a previous history of myelodysplastic syndromes (MDS) or MDS/myeloproliferative neoplasm (MDS-MPN). The transition from the World Health Organization (WHO) 2016 classification to the 2022 WHO and International Consensus Classification (ICC) systems reflects a paradigm shift from morphology-based definitions toward genomics-driven disease entities. However, while diagnostic precision has improved, translation of these classifications into clinically actionable strategies remains incomplete. This review critically examines the biological and prognostic implications of MRG mutations, their interaction with key molecular subgroups such as NPM1- and FLT3-mutated AML, and their impact on therapeutic decision-making. We highlight unresolved issues, including the context-dependent prognostic value of MRG mutations, limitations of static risk stratification, and the need to integrate measurable residual disease (MRD), genomics, and patient fitness into therapeutic algorithms. At the clinical level, many studies have explored the sensitivity of AML-MR to various induction treatments in both younger and older AML patients, with significant improvements in survival. The main objective of these different induction therapy strategies is to achieve a complete remission with minimal toxicity, particularly in older patients, allowing patients to proceed to allogeneic hematopoietic stem cell transplantation, the only curative option so far.
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Ethics Approval
: AML MDS-related; MDS/AML; WHO5; ICC; MRG Mutations; TP53.Supporting Agencies
no supporting agenciesHow to Cite
“ACUTE MYELOİD LEUKEMİA, MYELODYSPLASİA-RELATED: BEYOND CLASSİFİCATİON—TOWARD PRECİSİON DECİSİON-MAKİNG” (2026) Mediterranean Journal of Hematology and Infectious Diseases, 18(1), p. e2026075. doi:10.4084/MJHID.2026.075.
Copyright (c) 2026 G Leone, U Testa, E Attardi, MT Voso
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