Treatment strategies for acute myelogenous leukemia (AML) will be increasingly directed by molecular and cytogenetic disease features. However, drugs targeting single molecular checkpoints have shown limited success in AML. Thus, cytotoxic chemotherapy and allogeneic stem cell transplantation remain the mainstay of AML therapy, besides the emerging role of epigenetic concepts mainly represented by hypomethylating compounds. Therefore, cooperative concepts are needed in the future, integrating both cytotoreductive and molecular-targeted, as well as immunotherapeutic treatment approaches. To come up to the complexity of both molecular pathomechanisms and resulting treatment modalities, patients with AML should be treated within appropriately designed clinical studies whenever possible.