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Prognostic impact of the AML ELN2022 risk classification in patients undergoing allogeneic stem cell transplantation.
- Source :
-
Blood cancer journal [Blood Cancer J] 2022 Dec 19; Vol. 12 (12), pp. 170. Date of Electronic Publication: 2022 Dec 19. - Publication Year :
- 2022
-
Abstract
- For most patients with acute myeloid leukemia (AML), an allogeneic hematopoietic stem cell transplantation (HSCT) offers the highest chance of cure. Recently, the European LeukemiaNet (ELN) published updated recommendations on the diagnosis and risk classification in AML based on genetic factors at diagnosis as well as a dynamic adjustment (reclassification) according to the measurable residual disease (MRD) status for the favorable and intermediate risk groups. Validation of the ELN2022 risk classification has not been reported. We retrospectively analyzed 522 AML patients who received an HSCT at a median age of 59 (range 16-76) years. For patients with adequate material available and in remission prior to HSCT (nā=ā229), the MRD status was evaluated. Median follow-up after HSCT was 3.0 years. ELN2022 risk at diagnosis was in 22% favorable, in 26% intermediate, and in 52% adverse. ELN2022 risk at diagnosis is associated with the cumulative incidence of relapse/progression (CIR), event-free survival (EFS), and overall survival (OS) in the whole patient cohort, as well as the subgroup of patients transplanted in first remission. However, the risk stratification based on the ELN2022 classification did not significantly improve outcome prognostication in comparison to the ELN2017 classification. In our study, the newly added group of patients with myelodysplasia-related gene mutations did not have adverse outcomes. Re-classifying these patients into the intermediate risk group and adjusting the grouping for all AML patients by MRD at HSCT, led to a refined and improved risk stratification, which should be validated in independent studies.<br /> (© 2022. The Author(s).)
- Subjects :
- Humans
Adolescent
Young Adult
Adult
Middle Aged
Aged
Transplantation, Homologous adverse effects
Prognosis
Retrospective Studies
Neoplasm, Residual
Hematopoietic Stem Cell Transplantation adverse effects
Leukemia, Myeloid, Acute diagnosis
Leukemia, Myeloid, Acute therapy
Leukemia, Myeloid, Acute complications
Subjects
Details
- Language :
- English
- ISSN :
- 2044-5385
- Volume :
- 12
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- Blood cancer journal
- Publication Type :
- Academic Journal
- Accession number :
- 36529759
- Full Text :
- https://doi.org/10.1038/s41408-022-00764-9