Comparison of the 2022 and 2017 European LeukemiaNet risk classifications in a real-life cohort of the PETHEMA group

Autor: Claudia Sargas, Rosa Ayala, María J. Larráyoz, María C. Chillón, Eduardo Rodriguez-Arboli, Cristina Bilbao, Esther Prados de la Torre, David Martínez-Cuadrón, Rebeca Rodríguez-Veiga, Blanca Boluda, Cristina Gil, Teresa Bernal, Juan Bergua, Lorenzo Algarra, Mar Tormo, Pilar Martínez-Sánchez, Elena Soria, Josefina Serrano, Juan M. Alonso-Dominguez, Raimundo García, María Luz Amigo, Pilar Herrera-Puente, María J. Sayas, Esperanza Lavilla-Rubira, Joaquín Martínez-López, María J. Calasanz, Ramón García-Sanz, José A. Pérez-Simón, María T. Gómez Casares, Joaquín Sánchez-García, Eva Barragán, Pau Montesinos, PETHEMA cooperative study group
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Blood Cancer Journal, Vol 13, Iss 1, Pp 1-7 (2023)
Druh dokumentu: article
ISSN: 2044-5385
DOI: 10.1038/s41408-023-00835-5
Popis: Abstract Next-Generation Sequencing is needed for the accurate genetic risk stratification of acute myeloid leukemia according to European LeukemiaNet (ELN) guidelines. We validated and compared the 2022 ELN risk classification in a real-life cohort of 546 intensively and 379 non-intensively treated patients. Among fit patients, those aged ≥65 years old showed worse OS than younger regardless risk classification. Compared with the 2017 classification, 14.5% of fit patients changed the risk with the 2022 classification, increasing the high-risk group from 44.3% to 51.8%. 3.7% and 0.9% FLT3-ITD mutated patients were removed from the favorable and adverse 2017 categories respectively to 2022 intermediate risk group. We suggest that midostaurin therapy could be a predictor for 3 years OS (85.2% with vs. 54.8% without midostaurin, P = 0.04). Forty-seven (8.6%) patients from the 2017 intermediate group were assigned to the 2022 adverse-risk group as they harbored myelodysplasia (MDS)-related mutations. Patients with one MDS-related mutation did not reach median OS, while patients with ≥2 mutations had 13.6 months median OS (P = 0.002). Patients with TP53 ± complex karyotype or inv(3) had a dismal prognosis (7.1 months median OS). We validate the prognostic utility of the 2022 ELN classification in a real-life setting providing supportive evidences to improve risk stratification guidelines.
Databáze: Directory of Open Access Journals