Making Every AML Diagnosis a Path to Cure: Karilyn Larkin, MD

What would it mean if every single person diagnosed with acute myeloid leukemia (AML) had a clear, tailored path toward being cured—a path designed for them, based on their biology, their disease, their life?

This is what drives the ambition of Karilyn Larkin, MD, physician and associate professor of hematology at The Ohio State University Comprehensive Cancer Center–The James. A hematologic oncologist specializing in AML, Larkin treats patients, leads research, and sits at the intersection of where clinical medicine meets the genomic frontier. Her work is powered by the relationships with her patients that brought her here, and those same relationships keep pushing her deeper into the lab.

Larkin trained during a moment of dramatic transformation in AML care. As a fellow, conversations with elderly patients often came down to a brutal set of choices: a month in the hospital on aggressive chemotherapy or going home on supportive care. She watched patients—many of them older, living alone, hours from the nearest specialist—walk away from treatment because the options asked too much of them. That world is shifting: today, oral and targeted therapies are reaching people who would never have had access before.

As she put it, “It’s a rare time when you have somebody who you can’t get something for.” She described a 75-year-old patient living more than 3 hours away with no nearby support system, who is now nearly 2.5 years out from her diagnosis and managing beautifully at home on targeted therapy. “She wouldn’t have had that 10 years ago,” Larkin said.

But she is not yet declaring victory. The 5-year overall survival in AML hasn’t meaningfully moved, and Larkin is clear-eyed about what it will take to change that. The technology is accelerating—what once required sequencing a handful of genes can now map thousands of genomic alterations in the same timeframe and at comparable cost—and the data that accumulate from that revolution will help unlock who responds to which therapies and why.

In this interview, Larkin navigates some of the hardest conversations in medicine, including how she lays the groundwork with patients from day 1 so that when research opportunities arise, they feel like a next step rather than a gamble, as well as what she believes it will actually take to move the survival needle in AML.