Comparison of the 2022 and 2017 European LeukemiaNet risk classifications in a real-life cohort of the PETHEMA group

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...

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Detalles Bibliográficos
Autores: Sargas, C, Ayala, R, Larrayoz, MJ, Chillon, MC, Rodriguez-Arboli, E, Bilbao, C, de la Torre, EP, Martinez-Cuadron, D, Rodriguez-Veiga, R, Boluda, B, Gil, C, Bernal, T, Bergua, J, Algarra, L, Tormo, M, Martinez-Sanchez, P, Soria, E, Serrano, J, Alonso-Dominguez, JM, Garcia, R, Amigo, ML, Herrera-Puente, P, Sayas, MJ, Lavilla-Rubira, E, Martinez-Lopez, J, Calasanz, MJ, Garcia-Sanz, R, Perez-Simon, JA, Casares, MTG, Sanchez-Garcia, J, Barragan, E, Montesinos, P
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9741
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones9741
https://www.nature.com/articles/s41408-023-00835-5
Access Level:acceso abierto
Descripción
Sumario: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.

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