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Prognostic Index for Older Adult Patients with Newly Diagnosed Acute Myeloid Leukemia: The Edouard Herriot Hospital Experience

Authors :
Daniella Revesz
Franck E. Nicolini
Amine Belhabri
Claudiu Plesa
Mauricette Michallet
Sophie Ducastelle
Jacques Troncy
Isabelle Tigaud
Bruno Anglaret
Charles Dumontet
Xavier Thomas
Anne Thiebaut
Youcef Chelghoum
Mohamed Elhamri
Marie-Claire Perrin
Sandrine Hayette
Eric Wattel
Quoc-Hung Le
Source :
Clinical Leukemia. 2:198-204
Publication Year :
2008
Publisher :
Elsevier BV, 2008.

Abstract

Background The treatment of elderly adults with acute myeloid leukemia (AML) is associated with unsatisfactory rates of complete responses and long-term overall survival (OS). Therefore, a clinically useful prognostic index would facilitate therapeutic decision-making and evaluation of investigational treatment strategies in this patient population. Patients and Methods A prognostic score is presented based on the multivariate analysis of 432 patients with non-M3 AML aged > 60 years, selected on the basis of their initial performance status and the absence of severe comorbid factors for entering into 5 successive clinical trials combining an anthracycline and cytarabine. Four clinically relevant parameters are included in this index: cytogenetics at diagnosis, history of previous hematologic disorder, hematologic features at diagnosis, and lactate dehydrogenase level at diagnosis. Results Using this stratification system, 3 risk groups were defined: a favorable-risk group A (OS of 39% at 2 years and 21% at 5 years), an intermediate-risk group B (OS of 19% at 2 years and 8% at 5 years), and a poor-risk group C (OS of 5% at 2 years and 0 at 5 years). Conclusion The prognostic index estimates the outcome of elderly patients with AML usually selected for intensive chemotherapy trials using 4 easily determined parameters and might identify patients who are really candidates for this treatment strategy from those for whom investigational therapy or palliation might be most appropriate.

Details

ISSN :
19316925
Volume :
2
Database :
OpenAIRE
Journal :
Clinical Leukemia
Accession number :
edsair.doi...........3806da54451597d31630c13188ce3868
Full Text :
https://doi.org/10.3816/clk.2008.n.025