Prognostic analysis according to the 2017 ELN risk stratification by genetics in adult acute myeloid leukemia patients treated in the Japan Adult Leukemia Study Group (JALSG) AML201 study

被引：41

作者：

Harada, Yasuhiko ^{[1
]}

Nagata, Yasunobu ^{[2
,3
]}

Kihara, Rika ^{[1
]}

Ishikawa, Yuichi ^{[1
]}

Asou, Norio ^{[4
]}

Ohtake, Shigeki ^{[5
]}

Miyawaki, Shuichi ^{[6
]}

Sakura, Toru ^{[7
]}

Ozawa, Yukiyasu ^{[8
]}

Usui, Noriko ^{[9
]}

Kanamori, Heiwa ^{[10
]}

Ito, Yoshikazu ^{[11
]}

Imai, Kiyotoshi ^{[12
]}

Suehiro, Youko ^{[13
]}

Kobayashi, Shinichi ^{[14
]}

Kitamura, Kunio ^{[15
]}

Sakaida, Emiko ^{[16
]}

Onizuka, Makoto ^{[17
]}

Takeshita, Akihiro ^{[18
]}

Ishida, Fumihiro ^{[19
]}

Suzushima, Hitoshi ^{[20
]}

Ishizawa, Kenichi ^{[21
]}

Naoe, Tomoki ^{[22
]}

Matsumura, Itaru ^{[23
]}

Miyazaki, Yasushi ^{[24
]}

Ogawa, Seishi ^{[2
]}

Kiyoi, Hitoshi ^{[1
]}

机构：

[1] Nagoya Univ, Dept Hematol & Oncol, Grad Sch Med, Nagoya, Aichi, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Pathol & Tumor Biol, Kyoto, Japan

[3] Cleveland Clin, Dept Translat Hematol & Oncol Res, Taussig Canc Inst, Cleveland, OH 44106 USA

[4] Saitama Med Univ, Int Med Ctr, Dept Hematol, Hidaka, Japan

[5] Kanazawa Univ, Kanazawa, Ishikawa, Japan

[6] Tokyo Metropolitan Otsuka Hosp, Div Hematol, Tokyo, Japan

[7] Saiseikai Maebashi Hosp, Leukemia Res Ctr, Maebashi, Gunma, Japan

[8] Japanese Red Cross Nagoya First Hosp, Dept Hematol, Nagoya, Aichi, Japan

[9] Jikei Univ, Dept Internal Med, Div Clin Oncol & Hematol, Sch Med, Tokyo, Japan

[10] Kanagawa Canc Ctr, Dept Hematol, Yokohama, Kanagawa, Japan

[11] Tokyo Med Univ, Dept Hematol, Tokyo, Japan

[12] Sapporo Hokuyu Hosp, Dept Hematol, Sapporo, Hokkaido, Japan

[13] Natl Hosp Org Kyushu Canc Ctr, Dept Hematol, Fukuoka, Japan

[14] Natl Def Med Coll, Dept Internal Med, Div Hematol, Saitama, Japan

[15] Ichinomiya Municipal Hosp, Div Hematol, Ichinomiya, Japan

[16] Chiba Univ Hosp, Dept Hematol, Chiba, Japan

[17] Tokai Univ, Dept Hematol Oncol, Sch Med, Isehara, Kanagawa, Japan

[18] Hamamatsu Univ Sch Med, Dept Internal Med, Hamamatsu, Shizuoka, Japan

[19] Shinshu Univ, Dept Internal Med, Div Hematol, Sch Med, Matsumoto, Nagano, Japan

[20] Kumamoto Shinto Gen Hosp, Dept Hematol, Kumamoto, Japan

[21] Yamagata Univ, Dept Internal Med 3, Div Hematol & Cell Therapy, Fac Med, Yamagata, Japan

[22] Natl Hosp Org Nagoya Med Ctr, Nagoya, Aichi, Japan

[23] Kindai Univ, Fac Med, Dept Hematol & Rheumatol, Osaka, Japan

[24] Nagasaki Univ, Atom Bomb Dis Inst, Dept Hematol, Grad Sch Biomed Sci, Nagasaki, Japan

来源：

LEUKEMIA RESEARCH | 2018年 / 66卷

关键词：

Acute myeloid leukemia; Prognosis; Risk stratification; European LeukemiaNet; Genetics; SOMATIC MUTATIONS; RECOMMENDATIONS; MANAGEMENT; DIAGNOSIS; TET2; FLT3;

D O I：

10.1016/j.leukres.2018.01.008

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Many genetic alterations that are associated with the prognosis of acute myeloid leukemia (AML) have been identified, and several risk stratification systems based on the genetic status have been recommended. The European LeukemiaNet (ELN) first proposed the risk stratification system for AML in 2010 (ELN-2010), and recently published the revised system (ELN-2017). We validated the long-term prognosis and clinical characteristics of each ELN-2017 risk category in Japanese adult AML patients who were treated in the Japan Adult Leukemia Study Group (JALSG) AML-201 study. We demonstrated that the 3-risk category system of the ELN2017 successfully discriminated the overall survival and complete remission rates in our cohort in comparison with the 4-risk category of the ELN-2010. However, there were still genetic categories in which stratification of patients into favorable or intermediate risk categories was controversial; the low allelic ratio of FLT3-ITD was not necessarily associated with a better prognosis in patients with FLT3-ITD, and cytogenetic abnormalities may affect the prognosis in patients with favorable genetic lesions such as NPM1 and CEBPA mutations. As many molecular targeting agents, such as FLT3 inhibitors, have been developed, we must continue to modify the genetic risk stratification system to match the progression of therapeutic strategies.

引用

页码：20 / 27

页数：8

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