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Combined molecular and clinical prognostic index for relapse and survival in cytogenetically normal acute myeloid leukemia.
J. Clin. Oncol. 32, 1586-1594 (2014)
PURPOSE: Cytogenetically normal (CN) acute myeloid leukemia (AML) is the largest and most heterogeneous cytogenetic AML subgroup. For the practicing clinician, it is difficult to summarize the prognostic information of the growing number of clinical and molecular markers. Our purpose was to develop a widely applicable prognostic model by combining well-established pretreatment patient and disease characteristics. PATIENTS AND METHODS: Two prognostic indices for CN-AML (PINA), one regarding overall survival (OS; PINAOS) and the other regarding relapse-free survival (RFS; PINARFS), were derived from data of 572 patients with CN-AML treated within the AML Cooperative Group 99 study (www.aml-score.org. RESULTS: On the basis of age (median, 60 years; range, 17 to 85 years), performance status, WBC count, and mutation status of NPM1, CEBPA, and FLT3-internal tandem duplication, patients were classified into the following three risk groups according to PINAOS and PINARFS: 29% of all patients and 32% of 381 responding patients had low-risk disease (5-year OS, 74%; 5-year RFS, 55%); 56% of all patients and 39% of responding patients had intermediate-risk disease (5-year OS, 28%; 5-year RFS, 27%), and 15% of all patients and 29% of responding patients had high-risk disease (5-year OS, 3%; 5-year RFS, 5%), respectively. PINAOS and PINARFS stratified outcome within European LeukemiaNet genetic groups. Both indices were confirmed on independent data from Cancer and Leukemia Group B/Alliance trials. CONCLUSION: We have developed and validated, to our knowledge, the first prognostic indices specifically designed for adult patients of all ages with CN-AML that combine well-established molecular and clinical variables and that are easily applicable in routine clinical care. The integration of both clinical and molecular markers could provide a basis for individualized patient care through risk-adapted therapy of CN-AML.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Acute Myelogenous Leukemia; Internal Tandem Duplication; Single Cebpa Mutations; Aged 60 Years; Group-b; Elderly-patients; Normal Karyotype; Favorable Prognosis; Complete Remission; Gene-mutations
Language
english
Publication Year
2014
HGF-reported in Year
2014
ISSN (print) / ISBN
0732-183X
e-ISSN
1527-7755
Quellenangaben
Volume: 32,
Issue: 15,
Pages: 1586-1594
Publisher
American Society of Clinical Oncology
Publishing Place
Alexandria
Reviewing status
Peer reviewed
Institute(s)
CCG Pathogenesis of Acute Myeloid Leukemia (KKG-KPL)
POF-Topic(s)
30504 - Mechanisms of Genetic and Environmental Influences on Health and Disease
Research field(s)
Immune Response and Infection
PSP Element(s)
G-521000-001
PubMed ID
24711548
WOS ID
WOS:000336733000013
Scopus ID
84903821162
Erfassungsdatum
2014-04-10