Validation of the Revised 2022 European LeukemiaNet Risk Stratification in Adult Patients with Acute Myeloid Leukemia.

Autor:	Ruhnke L; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Bill M; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Zukunft S; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Eckardt JN; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Schäfer S; National Center for Tumor Diseases Dresden (NCT/UCC), Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Stasik S; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Hanoun M; Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany, Germany., Schroeder T; Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany, Germany., Fransecky L; Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, Germany., Steffen B; Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany, Germany., Krause SW; Uni-Klinikum Erlangen, Erlangen, Germany., Scholl S; Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Jena, Germany, Germany., Hochhaus A; Department of Internal Medicine II, Hematology and Medical Oncology, University Hospital Jena, Jena, Germany, Germany., Sauer T; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany, Germany., Kraus S; Uniklinikum Würzburg, Würzburg, Germany., Schäfer-Eckart K; Klinikum Nuernberg, Nuernberg, Germany., Kaufmann M; Robert Bosch Hospital Stuttgart, Stuttgart, Germany., Jost E; Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital Aachen & CIO ABCD Aachen, RWTH Aachen, Aachen, Germany, Germany., Brümmendorf TH; Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, University Hospital Aachen & CIO ABCD Aachen, RWTH Aachen, Aachen, Germany, Germany., Schliemann C; Department of Medicine A, University Hospital Münster, Münster, Germany, Germany., Mikesch JH; Department of Medicine A, University Hospital Münster, Münster, Germany, Germany., Krug U; Klinikum Leverkusen, Leverkusen, Germany., Hänel M; Department of Internal Medicine III, Klinikum Chemnitz, Chemnitz, Germany, Germany., Morgner A; Department of Internal Medicine III, Klinikum Chemnitz, Chemnitz, Germany, Germany., Schaich M; Rems-Murr-Klinikum Winnenden, Winnenden, Germany., Neubauer A; Philipps-University, Marburg, Germany., Repp R; 2. Medizinische Klinik, Städtisches Krankenhaus Kiel, Kiel, Germany., Niemann D; Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany., Seggewiss-Bernhardt R; Department of Internal Medicine V, Sozialstiftung Bamberg, Bamberg, Germany., Meinhardt A; Agaplesion Diakonieklinikum Rotenburg, Achim, Germany., Kullmer J; DIAKO Bremen, Bremen, Germany., Kaiser U; St. Bernward Krankenhaus, Hildesheim, Germany., Blau W; Helios Dr. Horst Schmidt Klinikum Wiesbaden, Wiesbaden, Germany., Kiani A; Klinikum Bayreuth, Bayreuth, Germany., Grigoleit GU; Klinikum Kassel, Kassel, Germany., Giagounidis A; Marien Hospital, DÃ1/4sseldorf, Germany., Wurm AA; National Center for Tumor Diseases Dresden (NCT/UCC), Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany., Altmann H; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Middeke JMM; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Schetelig J; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Müller-Tidow C; Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany, Germany., Stölzel F; Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, Germany., Baldus CD; Department of Hematology and Oncology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany, Germany., Platzbecker U; University Hospital Leipzig, Department of Hematology and Cell Therapy, Leipzig, Germany., Serve H; Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany, Germany., Bornhäuser M; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany., Thiede C; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany and Agendix GmbH, Dresden, Germany, Germany., Röllig C; Department of Internal Medicine I, University Hospital Dresden, TU Dresden, Dresden, Germany, Germany.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2024 Nov 06. Date of Electronic Publication: 2024 Nov 06.
DOI:	10.1182/bloodadvances.2024013304
Abstrakt:	In 2022, the European LeukemiaNet (ELN) risk stratification for patients with AML has been updated. We aimed to validate the prognostic value of the 2022 ELN classification (ELN22) evaluating 1,570 newly diagnosed AML patients (median age, 56 years) treated with cytarabine-based intensive chemotherapy regimens. As compared to the 2017 ELN classification (ELN17), allocating 595 (38%), 413 (26%) and 562 (36%) patients to the favorable, intermediate and adverse risk category, ELN22 risk was favorable, intermediate, and adverse in 575 (37%), 410 (26%), and 585 (37%) patients, respectively. Risk group allocation was revised in 340 patients (22%). Most patients were re-classified into ELN22 intermediate or ELN22 adverse risk group. The allocation of patients according to the ELN22 risk categories resulted in a significantly distinct event-free survival (EFS), relapse-free survival (RFS), and overall survival (OS). As compared to ELN17, reallocation according to the ELN22 recommendations resulted in a significantly improved prognostic discrimination for OS (3-year area under the curve (AUC) 0.71 vs. 0.67). In patients with ELN22 favorable risk AML, co-occurring MR gene mutations did not significantly impact outcome. Within the ELN22 adverse risk group, we observed marked survival differences across mutational groups (5-year OS rate of 21% and 3% in patients with myelodysplasia-related (MR) gene mutations and TP53-mutated patients, respectively). In patients harboring MR gene mutations, EZH2-, STAG2- and ZRSR2-mutated patients showed an intermediate-like OS. In patients with secondary AML and those who underwent allogeneic HCT, EFS and OS significantly differed between ELN22 risk groups, while prognostic abilities of ELN17 and ELN22 classifications were similar. In conclusion, the ELN22 risk stratification improves prognostic discrimination in a large cohort of intensively treated AML patients. Given the heterogeneous outcome in patients with MR gene alterations, ranging between those of intermediate and adverse risk patients, we suggest reevaluation of risk allocation in these patients. (Copyright © 2024 American Society of Hematology.)
Databáze:	MEDLINE
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