Document Detail


Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia.
MedLine Citation:
PMID:  22987078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-09-17
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  30     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-18     Completed Date:  2013-05-07     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4515-23     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Clinical Trials as Topic
Cytogenetics
Disease-Free Survival
Europe
Female
Humans
Leukemia, Myeloid, Acute / genetics*,  therapy*
Male
Middle Aged
Multivariate Analysis
Prognosis
Remission Induction
Risk Factors
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
CA101140/CA/NCI NIH HHS; CA114725/CA/NCI NIH HHS; CA129657/CA/NCI NIH HHS; CA140158/CA/NCI NIH HHS; CA16058/CA/NCI NIH HHS; CA31946/CA/NCI NIH HHS; CA33601/CA/NCI NIH HHS; CA77658/CA/NCI NIH HHS; P50 CA140158/CA/NCI NIH HHS
Comments/Corrections
Comment In:
Nat Rev Clin Oncol. 2012 Nov;9(11):607   [PMID:  23026876 ]
J Clin Oncol. 2013 Jun 20;31(18):2360-1   [PMID:  23650414 ]
J Clin Oncol. 2013 Jun 20;31(18):2361-2   [PMID:  23930275 ]

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