Introduction
The treatment landscape for acute myeloid leukemia (AML) has shifted dramatically from a morphology-based approach to one governed by molecular genetics. CPX-351, a liposomal formulation of cytarabine and daunorubicin in a fixed 5:1 molar ratio, was initially approved based on its superior overall survival (OS) compared to the standard 7+3 regimen in older patients with previously untreated, high-risk AML. However, the original trial (NCT01696084) utilized clinical and morphological definitions that have since been superseded by the World Health Organization (WHO) 5th Edition and International Consensus Classification (ICC). A critical question remained: Does the survival benefit of CPX-351 apply broadly to high-risk patients, or is it restricted to specific molecularly defined subgroups?
