PURPOSE: The treatment of acute myeloid leukemia (AML) in first relapse is associated with unsatisfactory rates of complete responses that usually are short lived. Therefore, a clinically useful prognostic index can facilitate therapeutic decision making and evaluation of investigational treatment strategies at relapse of AML. PATIENTS AND METHODS: A prognostic score is presented based on the multivariate analysis of 667 AML patients in first relapse among 1,540 newly diagnosed non-M3 AML patients (age 15 to 60 years) entered onto three successive Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group trials. RESULTS: Four clinically relevant parameters are included in this index (ie, length of relapse-free interval after first complete remission, cytogenetics at diagnosis, age at relapse, and whether previous stem-cell transplantation was performed). Using this stratification system, three risk groups were defined: a favorable prognostic group A (overall survival [OS] of 70% at 1 year and 46% at 5 years), an intermediate-risk group B (OS of 49% at 1 year and 18% at 5 years), and a poor-risk group C (OS of 16% at 1 year and 4% at 5 years). CONCLUSION: The prognostic index estimates the outcome of AML patients in first relapse using four commonly applied clinical parameters and might identify patients who are candidates for salvage and investigational therapy.
PURPOSE: The treatment of acute myeloid leukemia (AML) in first relapse is associated with unsatisfactory rates of complete responses that usually are short lived. Therefore, a clinically useful prognostic index can facilitate therapeutic decision making and evaluation of investigational treatment strategies at relapse of AML. PATIENTS AND METHODS: A prognostic score is presented based on the multivariate analysis of 667 AMLpatients in first relapse among 1,540 newly diagnosed non-M3 AMLpatients (age 15 to 60 years) entered onto three successive Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group trials. RESULTS: Four clinically relevant parameters are included in this index (ie, length of relapse-free interval after first complete remission, cytogenetics at diagnosis, age at relapse, and whether previous stem-cell transplantation was performed). Using this stratification system, three risk groups were defined: a favorable prognostic group A (overall survival [OS] of 70% at 1 year and 46% at 5 years), an intermediate-risk group B (OS of 49% at 1 year and 18% at 5 years), and a poor-risk group C (OS of 16% at 1 year and 4% at 5 years). CONCLUSION: The prognostic index estimates the outcome of AMLpatients in first relapse using four commonly applied clinical parameters and might identify patients who are candidates for salvage and investigational therapy.
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Authors: Nicholas J Short; Hagop Kantarjian; Farhad Ravandi; Xuelin Huang; Lianchun Xiao; Guillermo Garcia-Manero; William Plunkett; Varsha Gandhi; Koji Sasaki; Naveen Pemmaraju; Naval G Daver; Gautam Borthakur; Nitin Jain; Marina Konopleva; Zeev Estrov; Tapan M Kadia; William G Wierda; Courtney D DiNardo; Mark Brandt; Susan M O'Brien; Jorge E Cortes; Elias Jabbour Journal: Leuk Lymphoma Date: 2017-07-18
Authors: Marina Konopleva; Daniel A Pollyea; Jalaja Potluri; Brenda Chyla; Leah Hogdal; Todd Busman; Evelyn McKeegan; Ahmed Hamed Salem; Ming Zhu; Justin L Ricker; William Blum; Courtney D DiNardo; Tapan Kadia; Martin Dunbar; Rachel Kirby; Nancy Falotico; Joel Leverson; Rod Humerickhouse; Mack Mabry; Richard Stone; Hagop Kantarjian; Anthony Letai Journal: Cancer Discov Date: 2016-08-12 Impact factor: 39.397