Moderator: Prof Abinya

Speakers & Topics:

• Dr Anne Mwirigi: Local Experience at a Tertiary Hospital
• Dr Rohini Radia: The Role of Cytogenetics & Molecular Markers
• Dr Peter Oyiro: Genomic Classification & Medical Oncology Pathways
• Dr Beatrice Jepngetich: Panelist Discussion
• Dr Mercy Gatua: Panelist Discussion

 Summary

AML is genetically heterogeneous, with most patients having multiple driver mutations.
– WHO 2022 classification emphasizes genetic abnormalities over morphology or blast count.
– Defining cytogenetic lesions like inv(16) or t(8;21) now suffice for diagnosis even with <20% blasts.

Diagnostic Work-Up

– FBC and peripheral blood smear
– Bone marrow aspirate: morphology, flow cytometry, LAIP for MRD
– Cytogenetics: Karyotyping and FISH
– Next-Generation Sequencing (NGS): TP53, NPM1, etc.
– Bone marrow trephine with immunocytochemistry.

Clinical Implications

– Risk stratification through cytogenetics + molecular testing informs prognosis and treatment plan.
– Favorable-risk patients may receive chemotherapy; adverse-risk patients considered for early allogeneic transplant.
– MRD monitoring increasingly guides transplant decisions.

Takeaways

– AML is curable in a subset with intensive chemo + risk-adapted approach.
– Precision oncology depends on accessible molecular diagnostics.
– LMICs face challenges integrating NGS-based stratification.
– Hypomethylating agents + Venetoclax offer promise in select patient groups.