Validation of the prognostic significance of the 2022 European LeukemiaNet risk stratification system in intensive chemotherapy treated aged 18 to 65 years patients with de novo acute myeloid leukemia.

Autor: Lo MY; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan.; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Tsai XC; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Department of Medical Education and Research, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan., Lin CC; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan., Tien FM; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Kuo YY; Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipei, Taiwan., Lee WH; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan., Peng YL; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Liu MC; Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan., Tseng MH; Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipei, Taiwan., Hsu CA; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan., Chen JC; Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan., Lin LI; Department of Clinical Laboratory Sciences and Medical Biotechnology, College of Medicine, National Taiwan University, Taipei, Taiwan., Sun HI; Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipei, Taiwan., Chuang YK; Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipei, Taiwan., Ko BS; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Tai-Chen Stem Cell Therapy Center, National Taiwan University, Taipei, Taiwan.; Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan., Tang JL; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan., Yao M; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Chou WC; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan., Hou HA; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Tien HF; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Department of Internal Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan.
Jazyk: angličtina
Zdroj: American journal of hematology [Am J Hematol] 2023 May; Vol. 98 (5), pp. 760-769. Date of Electronic Publication: 2023 Mar 13.
DOI: 10.1002/ajh.26892
Abstrakt: The European LeukemiaNet (ELN) recently proposed a revised recommendation for the diagnosis and management of acute myeloid leukemia (AML) in adults, recognized as ELN-2022. However, validation in a large real-world cohort remains lacking. In this study, we aimed to validate the prognostic relevance of the ELN-2022 in a cohort of 809 de novo, non-M3, younger (ages 18-65 years) AML patients receiving standard chemotherapy. The risk categories of 106 (13.1%) patients were reclassified from that determined using ELN-2017 to that determined using ELN-2022. The ELN-2022 effectively helped distinguish patients as favorable, intermediate, and adverse risk groups in terms of remission rates and survival. Among patients who achieved first complete remission (CR1), allogeneic transplantation was beneficial for those in the intermediate risk group, but not for those in the favorable or adverse risk groups. We further refined the ELN-2022 system by re-categorizing AML patients with t(8;21)(q22;q22.1)/RUNX1::RUNX1T1 with KIT high , JAK2 or FLT3-ITD high mutations into the intermediate risk subset, AML patients with t(7;11)(p15;p15)/NUP98::HOXA9 and AML patients with co-mutated DNMT3A and FLT3-ITD into the adverse risk subsets, and AML patients with complex or monosomal karyotypes, inv (3)(q21.3q26.2) or t(3;3)(q21.3;q26.2)/GATA2,MECOM(EVI1) or TP53 mutation into the very adverse risk subset. The refined ELN-2022 system performed effectively to distinguish patients as favorable, intermediate, adverse, and very adverse risk groups. In conclusion, the ELN-2022 helped distinguish younger, intensively treated patients into three groups with distinct outcomes; the proposed refinement of ELN-2022 may further improve risk stratification among AML patients. Prospective validation of the new predictive model is necessary.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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