Clonal evolution of AML: current conceptions and clinical observations
https://doi.org/10.35754/0234-5730-2026-71-1-120-133
Abstract
Introduction. Acute myeloid leukemia (AML) is characterized by a complex clonal structure formed as a result of clonal evolution. The study of clonal evolution is dictated by the need to improve the effectiveness of therapeutic strategies for AML.
Aim: to review the current understanding of the clonal evolution of AML and analyze clonal evolution in real clinical practice using the example of three clinical cases.
Main findings. A description of clinical cases with AML clonal evolution included 3 patients with newly diagnosed AML. Molecular genetic analysis of FLT3 and NPM1 genes was performed using commercial kits. The article reviews the main models of clonal evolution of AML: linear and parallel. The data from the study of leukemic stem cells are presented. Clonal evolution is demonstrated using the example of three clinical observations, explanations and recommendations for the selection of therapy are given. The clonal evolution of AML is a long and continuous process, which results in the formation of a complex branching pattern of molecular genetic breakdowns involving the leukemia stem cells. In this regard, at all stages of AML development (onset, remission, relapse), it is necessary to diagnose the maximum number of molecular genetic markers. Treatment taking into account knowledge of the patterns of clonal evolution is likely to improve the effectiveness of therapy.
Supporting agencies: the work was funded by Russian Science Foundation, grant No. 19-75-20128.
About the Authors
А. А. Shatilova
Institute of Cytology RAS ; VA Almazov National Medical Research Center ; Central Municipal Hospital ; Institute of Medicine and Life Sciences (MEDBIO), Immanuel Kant Baltic Federal University (IKBFU)
Russian Federation
Russian Federation
Alexina A. Shatilova, Cand. Sci. (Med.), junior researcher; hematologist; senior teacher
194064, Saint-Petersburg
197341, Saint-Petersburg
236005, Kaliningrad
236016, Kaliningrad
L. L. Girshova
VA Almazov National Medical Research Center
Russian Federation
Russian Federation
Larisa L. Girshova, Cand. Sci. (Med.), hematologist
197341, Saint-Petersburg
I. G. Budaeva
VA Almazov National Medical Research Center
Russian Federation
Russian Federation
Irina G. Budaeva, hematologist
197341, Saint-Petersburg
O. N. Demidov
Institute of Cytology RAS
Russian Federation
Russian Federation
Oleg N. Demidov, Dr. Sci. (Med.), leading scientist
194064, Saint-Petersburg
E. V. Belotserkovskaya
Institute of Cytology RAS
Russian Federation
Russian Federation
Ekaterina V. Belotserkovskaya, Cand. Sci. (Med.), senior scientist
194064, Saint-Petersburg
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For citations:
Shatilova А.А., Girshova L.L., Budaeva I.G., Demidov O.N., Belotserkovskaya E.V. Clonal evolution of AML: current conceptions and clinical observations. Russian journal of hematology and transfusiology. 2026;71(1):120-133. (In Russ.) https://doi.org/10.35754/0234-5730-2026-71-1-120-133
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