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Evolutionary trajectory of AML
al-intrinsic as well as environmental factors. Both factors are influenced by each patient’s germline background. We can improve our understanding firstly by depicting the exact route that pre-leukemic clones take on their way to becoming AML. It is important to remember that the trajectory of these clones does not end when patients achieve a complete (even molecular) remission. Residual, as well as new pre-leukemic clones, continue to evolve
along the same path. Familiarizing ourselves with the ontogeny of AML and incorporating it into clinical prac- tice will expand our therapeutic opportunities and grant us additional time points for intervention. Most impor- tantly, a truly holistic treatment must also consider the environmental pressures under which AML evolved and address them. This will give a comprehensive meaning to the term "cure".
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