European LeukemiaNet 2017 risk stratification for acute myeloid leukemia: validation in a risk-adapted protocol

The 2017 European LeukemiaNet (ELN 2017) guidelines for the diagnosis and management of acute myeloid leukemia (AML) have become fundamental guidelines to assess the prognosis and postremission therapy of patients. However, they have been retrospectively validated in few studies with patients includ...

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Detalhes bibliográficos
Autores: Bataller, Alex, Garrido, Ana, Guijarro Tomàs, Francisca, Oñate, Guadalupe, Díaz Beyà, Marina, Arnan, Montserrat, Tormo, Mar, Vives, Susana, Queipo de Llano, María Paz, Coll, Rosa, Gallardo, David, Vall Llovera, Ferran, Escoda, Lourdes, Garcia Guiñon, Antonio, Salamero, Olga, Sampol, Antonia, Merchan, Brayan M., Bargay, Joan, Castaño Díez, Sandra, Esteban, Daniel, Oliver Caldés, Aina, Rivero, Andrea, Mozas, Pablo, López-Guerra, Mónica, Pratcorona, Marta, Zamora, Lurdes, Costa, Dolors, Rozman, Maria, Nomdedéu Guinot, Josep Francesc, Colomer Pujol, Dolors, Brunet, Salut, Sierra Gil, Jorge, Esteve Reyner, Jordi
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/184411
Acesso em linha:https://hdl.handle.net/2445/184411
Access Level:acceso abierto
Palavra-chave:Leucèmia mieloide
Programes de prevenció
Myeloid leukemia
Prevention programs
Descrição
Resumo:The 2017 European LeukemiaNet (ELN 2017) guidelines for the diagnosis and management of acute myeloid leukemia (AML) have become fundamental guidelines to assess the prognosis and postremission therapy of patients. However, they have been retrospectively validated in few studies with patients included in different treatment protocols. We analyzed 861 patients included in the Cooperativo Para el Estudio y Tratamiento de las Leucemias Agudas y Mielodisplasias-12 risk-adapted protocol, which indicates cytarabine-based consolidation for patients allocated to the ELN 2017 favorable-risk group, whereas it recommends allogeneic stem cell transplantation (alloSCT) as a postremission strategy for the ELN 2017 intermediateand adverse-risk groups. We retrospectively classified patients according to the ELN 2017, with 327 (48%), 109 (16%), and 245 (36%) patients allocated to the favorable-, intermediate-, and adverse-risk group, respectively. The 2- and 5-year overall survival (OS) rates were 77% and 70% for favorable-risk patients, 52% and 46% for intermediate-risk patients, and 33% and 23% for adverse-risk patients, respectively. Furthermore, we identified a subgroup of patients within the adverse group (inv(3)/t(3;3), complex karyotype, and/or TP53 mutation/17p abnormality) with a particularly poor outcome, with a 2-year OS of 15%. Our study validates the ELN 2017 risk stratification in a large cohort of patients treated with an ELN-2017 risk-adapted protocol based on alloSCT after remission for nonfavorable ELN subgroups and identifies a genetic subset with a very poor outcome that warrants investigation of novel strategies.

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