Combined Molecular and Clinical Prognostic Index for Relapse and Survival in Cytogenetically Normal Acute Myeloid Leukemia | Zendy

Friederike Pastore | Zendy; Annika Dufour | Zendy; Tobias Benthaus | Zendy; Klaus H. Metzeler | Zendy; Kati Maharry | Zendy; Stephanie Schneider | Zendy; Bianka Ksienzyk | Zendy; Gudrun Mellert | Zendy; Evelyn Zellmeier | Zendy; Purvi M. Kakadia | Zendy; Michael Unterhalt | Zendy; Michaela FeuringBuske | Zendy; Christian Buske | Zendy; Jan Braess | Zendy; Maria Cristina Sauerland | Zendy; Achim Heinecke | Zendy; Utz Krug | Zendy; Wolfgang E. Berdel | Zendy; Thomas Buechner | Zendy; Bernhard J. Woermann | Zendy; Wolfgang Hiddemann | Zendy; Stefan K. Bohlander | Zendy; Guido Marcucci | Zendy; Karsten Spiekermann | Zendy; Clara D. Bloomfield | Zendy; Eva Hoster | Zendy

Open Access

Combined Molecular and Clinical Prognostic Index for Relapse and Survival in Cytogenetically Normal Acute Myeloid Leukemia

Author(s) -

Friederike Pastore,

Annika Dufour,

Tobias Benthaus,

Klaus H. Metzeler,

Kati Maharry,

Stephanie Schneider,

Bianka Ksienzyk,

Gudrun Mellert,

Evelyn Zellmeier,

Purvi M. Kakadia,

Michael Unterhalt,

Michaela FeuringBuske,

Christian Buske,

Jan Braess,

Maria Cristina Sauerland,

Achim Heinecke,

Utz Krug,

Wolfgang E. Berdel,

Thomas Buechner,

Bernhard J. Woermann,

Wolfgang Hiddemann,

Stefan K. Bohlander,

Guido Marcucci,

Karsten Spiekermann,

Clara D. Bloomfield,

Eva Hoster

Publication year - 2014

Publication title -

journal of clinical oncology

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 10.482

H-Index - 548

eISSN - 1527-7755

pISSN - 0732-183X

DOI - 10.1200/jco.2013.52.3480

Subject(s) - medicine , cebpa , npm1 , myeloid leukemia , oncology , disease , leukemia , karyotype , mutation , gene , biochemistry , chemistry , chromosome

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; PINA OS ) and the other regarding relapse-free survival (RFS; PINA RFS ), 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 PINA OS and PINA RFS : 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. PINA OS and PINA RFS 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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