| Prognostic Significance of the European LeukemiaNet Standardized System for Reporting Cytogenetic and Molecular Alterations in Adults With Acute Myeloid Leukemia. | |
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MedLine Citation:
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PMID: 22987078 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSETo evaluate the prognostic significance of the international European LeukemiaNet (ELN) guidelines for reporting genetic alterations in acute myeloid leukemia (AML). PATIENTS AND METHODSWe 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.ResultsThe 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. CONCLUSIONThe 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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Authors:
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Krzysztof Mrózek; Guido Marcucci; Deedra Nicolet; Kati S Maharry; Heiko Becker; Susan P Whitman; Klaus H Metzeler; Sebastian Schwind; Yue-Zhong Wu; Jessica Kohlschmidt; Mark J Pettenati; Nyla A Heerema; Annemarie W Block; Shivanand R Patil; Maria R Baer; Jonathan E Kolitz; Joseph O Moore; Andrew J Carroll; Richard M Stone; Richard A Larson; Clara D Bloomfield |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-17 |
Journal Detail:
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Title: Journal of clinical oncology : official journal of the American Society of Clinical Oncology Volume: - ISSN: 1527-7755 ISO Abbreviation: J. Clin. Oncol. Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309333 Medline TA: J Clin Oncol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Krzysztof Mrózek, Guido Marcucci, Deedra Nicolet, Kati S. Maharry, Heiko Becker, Susan P. Whitman, Klaus H. Metzeler, Sebastian Schwind, Yue-Zhong Wu, Jessica Kohlschmidt, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center; Nyla A. Heerema, The Ohio State University, Columbus, OH; Deedra Nicolet, Kati S. Maharry, and Jessica Kohlschmidt, Alliance for Clinical Trials in Oncology Statistics and Data Center, Mayo Clinic, Rochester, MN; Mark J. Pettenati, Comprehensive Cancer Center, Wake Forest University, Winston-Salem; Joseph O. Moore, Duke University Medical Center, Durham, NC; AnneMarie W. Block, Roswell Park Cancer Institute, Buffalo; Jonathan E. Kolitz, Monter Cancer Center, Hofstra North Shore-Long Island Jewish School of Medicine, Lake Success, NY; Shivanand R. Patil, University of Iowa, Iowa City, IA; Maria R. Baer, Greenebaum Cancer Center, University of Maryland, Baltimore, MD; Andrew J. Carroll, University of Alabama at Birmingham, Birmingham, AL; Richard M. Stone, Dana-Farber Cancer Institute, Boston, MA; and Richard A. Larson, University of Chicago, Chicago, IL. |
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