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Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia.

Publication ,  Journal Article
Mrózek, K; Marcucci, G; Nicolet, D; Maharry, KS; Becker, H; Whitman, SP; Metzeler, KH; Schwind, S; Wu, Y-Z; Kohlschmidt, J; Pettenati, MJ ...
Published in: J Clin Oncol
December 20, 2012

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.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 20, 2012

Volume

30

Issue

36

Start / End Page

4515 / 4523

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Risk Factors
  • Remission Induction
  • Prognosis
  • Oncology & Carcinogenesis
  • Nucleophosmin
  • Multivariate Analysis
  • Middle Aged
  • Male
 

Citation

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Mrózek, K., Marcucci, G., Nicolet, D., Maharry, K. S., Becker, H., Whitman, S. P., … Bloomfield, C. D. (2012). Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol, 30(36), 4515–4523. https://doi.org/10.1200/JCO.2012.43.4738
Mrózek, Krzysztof, Guido Marcucci, Deedra Nicolet, Kati S. Maharry, Heiko Becker, Susan P. Whitman, Klaus H. Metzeler, et al. “Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia.J Clin Oncol 30, no. 36 (December 20, 2012): 4515–23. https://doi.org/10.1200/JCO.2012.43.4738.
Mrózek K, Marcucci G, Nicolet D, Maharry KS, Becker H, Whitman SP, et al. Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol. 2012 Dec 20;30(36):4515–23.
Mrózek, Krzysztof, et al. “Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia.J Clin Oncol, vol. 30, no. 36, Dec. 2012, pp. 4515–23. Pubmed, doi:10.1200/JCO.2012.43.4738.
Mrózek K, Marcucci G, Nicolet D, Maharry KS, Becker H, Whitman SP, Metzeler KH, Schwind S, Wu Y-Z, Kohlschmidt J, Pettenati MJ, Heerema NA, Block AW, Patil SR, Baer MR, Kolitz JE, Moore JO, Carroll AJ, Stone RM, Larson RA, Bloomfield CD. Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol. 2012 Dec 20;30(36):4515–4523.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

December 20, 2012

Volume

30

Issue

36

Start / End Page

4515 / 4523

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Risk Factors
  • Remission Induction
  • Prognosis
  • Oncology & Carcinogenesis
  • Nucleophosmin
  • Multivariate Analysis
  • Middle Aged
  • Male