학술논문
Comparison of the 2022 and 2017 European LeukemiaNet risk classifications in a real-life cohort of the PETHEMA group
Document Type
article
Author
Claudia Sargas; Rosa Ayala; María J. Larráyoz; María C. Chillón; Eduardo Rodriguez-Arboli; Cristina Bilbao; Esther Prados de la Torre; David Martínez-Cuadrón; Rebeca Rodríguez-Veiga; Blanca Boluda; Cristina Gil; Teresa Bernal; Juan Bergua; Lorenzo Algarra; Mar Tormo; Pilar Martínez-Sánchez; Elena Soria; Josefina Serrano; Juan M. Alonso-Dominguez; Raimundo García; María Luz Amigo; Pilar Herrera-Puente; María J. Sayas; Esperanza Lavilla-Rubira; Joaquín Martínez-López; María J. Calasanz; Ramón García-Sanz; José A. Pérez-Simón; María T. Gómez Casares; Joaquín Sánchez-García; Eva Barragán; Pau Montesinos; PETHEMA cooperative study group
Source
Blood Cancer Journal, Vol 13, Iss 1, Pp 1-7 (2023)
Subject
Language
English
ISSN
2044-5385
Abstract
Abstract Next-Generation Sequencing is needed for the accurate genetic risk stratification of acute myeloid leukemia according to European LeukemiaNet (ELN) guidelines. We validated and compared the 2022 ELN risk classification in a real-life cohort of 546 intensively and 379 non-intensively treated patients. Among fit patients, those aged ≥65 years old showed worse OS than younger regardless risk classification. Compared with the 2017 classification, 14.5% of fit patients changed the risk with the 2022 classification, increasing the high-risk group from 44.3% to 51.8%. 3.7% and 0.9% FLT3-ITD mutated patients were removed from the favorable and adverse 2017 categories respectively to 2022 intermediate risk group. We suggest that midostaurin therapy could be a predictor for 3 years OS (85.2% with vs. 54.8% without midostaurin, P = 0.04). Forty-seven (8.6%) patients from the 2017 intermediate group were assigned to the 2022 adverse-risk group as they harbored myelodysplasia (MDS)-related mutations. Patients with one MDS-related mutation did not reach median OS, while patients with ≥2 mutations had 13.6 months median OS (P = 0.002). Patients with TP53 ± complex karyotype or inv(3) had a dismal prognosis (7.1 months median OS). We validate the prognostic utility of the 2022 ELN classification in a real-life setting providing supportive evidences to improve risk stratification guidelines.