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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Detalhes bibliográficos
Autores: Sargas, C., Ayala, R., Larráyoz, M.J., Chillón, M.C., Rodriguez-Arboli, E., Bilbao, C., Prados de la Torre, E., Martínez-Cuadrón, D., Rodríguez-Veiga, R., Boluda, B., Gil, C., Bernal, T., Bergua, J., Algarra, L., Tormo, M., Martínez-Sánchez, P., Soria, E., Serrano, J., Alonso-Dominguez, J.M., García, R., Amigo, M.L., Herrera-Puente, P., Sayas, M.J., Lavilla Rubira, Esperanza, Martínez-López, J., Calasanz, M.J., García-Sanz, R., Pérez-Simón, J.A., Gómez Casares, M.T., Sánchez-García, J., Barragán, E., Montesinos, P.
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Servizo Galego de Saúde (SERGAS)
Repositorio:RUNA. Repositorio da Consellería de Sanidade e Sergas
OAI Identifier:oai:runa.sergas.gal:20.500.11940/21251
Acesso em linha:https://portalcientifico.sergas.gal//documentos/647b6c971aa5b21dc44763c6
http://hdl.handle.net/20.500.11940/21251
Access Level:acceso abierto
Palavra-chave:Humans
Aged
Nucleophosmin
Leukemia, Myeloid, Acute
Prognosis
Risk Factors
Mutation
AS Lugo
CHULA
Descrição
Resumo: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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