Prognostic Significance of the European LeukemiaNet Standardized System for Reporting Cytogenetic and Molecular Alterations in Adults With Acute Myeloid Leukemia

被引：345

作者：

Mrozek, Krzysztof ^{[1
]}

Marcucci, Guido ^{[1
]}

Nicolet, Deedra ^{[1
,2
,3
]}

Maharry, Kati S. ^{[1
,2
,3
]}

Becker, Heiko ^{[1
]}

Whitman, Susan P. ^{[1
]}

Metzeler, Klaus H. ^{[1
]}

Schwind, Sebastian ^{[1
]}

Wu, Yue-Zhong ^{[1
]}

Kohlschmidt, Jessica ^{[1
,2
,3
]}

Pettenati, Mark J. ^{[4
]}

Heerema, Nyla A.

Block, AnneMarie W. ^{[6
]}

Patil, Shivanand R. ^{[8
]}

Baer, Maria R. ^{[9
]}

Kolitz, Jonathan E. ^{[7
]}

Moore, Joseph O. ^{[5
]}

Carroll, Andrew J. ^{[10
]}

Stone, Richard M. ^{[11
]}

Larson, Richard A. ^{[12
]}

Bloomfield, Clara D. ^{[1
]}

机构：

[1] Ohio State Univ, Ctr Comprehens Canc, Columbus, OH 43210 USA

[2] Mayo Clin, Alliance Clin Trials Oncol Stat, Rochester, MN USA

[3] Mayo Clin, Ctr Data, Rochester, MN USA

[4] Wake Forest Univ, Ctr Comprehens Canc, Winston Salem, NC 27109 USA

[5] Duke Univ, Med Ctr, Durham, NC USA

[6] Roswell Pk Canc Inst, Buffalo, NY 14263 USA

[7] Hofstra N Shore Long Isl Jewish Sch Med, Monter Canc Ctr, Lake Success, NY USA

[8] Univ Iowa, Iowa City, IA USA

[9] Univ Maryland, Greenebaum Canc Ctr, Baltimore, MD 21201 USA

[10] Univ Alabama Birmingham, Birmingham, AL USA

[11] Dana Farber Canc Inst, Boston, MA 02115 USA

[12] Univ Chicago, Chicago, IL 60637 USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2012年 / 30卷 / 36期

关键词：

INTERNAL TANDEM DUPLICATION; MICRORNA-EXPRESSION SIGNATURES; ACUTE MYELOGENOUS LEUKEMIA; SINGLE CEBPA MUTATIONS; AGE; 60; YEARS; GROUP-B; NPM1; MUTATIONS; OLDER PATIENTS; COMPLETE REMISSION; YOUNGER ADULTS;

D O I：

10.1200/JCO.2012.43.4738

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose To evaluate the prognostic significance of the international European LeukemiaNet (ELN) guidelines for reporting genetic alterations in acute myeloid leukemia (AML). Patients and Methods We analyzed 1,550 adults with primary AML, treated on Cancer and Leukemia Group B first-line trials, who had pretreatment cytogenetics and, for cytogenetically normal patients, mutational status of NPM1, CEBPA, and FLT3 available. We compared complete remission (CR) rates, disease-free survival (DFS), and overall survival (OS) among patients classified into the four ELN genetic groups (favorable, intermediate-I, intermediate-II, adverse) separately for 818 younger (age < 60 years) and 732 older (age >= 60 years) patients. Results The percentages of younger versus older patients in the favorable (41% v 20%; P<.001), intermediate-II (19% v 30%; P<.001), and adverse (22% v 31%; P<.001) genetic groups differed. The favorable group had the best and the adverse group the worst CR rates, DFS, and OS in both age groups. Both intermediate groups had significantly worse outcomes than the favorable but better than the adverse group. Intermediate-I and intermediate-II groups in older patients had similar outcomes, whereas the intermediate-II group in younger patients had better OS but not better CR rates or DFS than the intermediate-I group. The prognostic significance of ELN classification was confirmed by multivariable analyses. For each ELN group, older patients had worse outcomes than younger patients. Conclusion The ELN classification clearly separates the genetic groups by outcome, supporting its use for risk stratification in clinical trials. Because they have different proportions of genetic alterations and outcomes, younger and older patients should be reported separately when using the ELN classification. J Clin Oncol 30:4515-4523. (C) 2012 by American Society of Clinical Oncology

引用

页码：4515 / 4523

页数：9

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