Comparison and validation of the 2022 European LeukemiaNet guidelines in acute myeloid leukemia

医学 内科学 危险分层 诱导化疗 不利影响 髓系白血病 队列 风险评估 肿瘤科 化疗 计算机安全 计算机科学
作者
Curtis A. Lachowiez,Nicola Long,Jennifer N. Saultz,Arpita Gandhi,Laura F. Newell,Brandon Hayes‐Lattin,Richard T. Maziarz,Jessica Leonard,Daniel Bottomly,Shannon K. McWeeney,Jennifer Dunlap,Richard D. Press,Gabrielle Meyers,Ronan T. Swords,Rachel J. Cook,Jeffrey W. Tyner,Brian J. Druker,Elie Traer
出处
期刊:Blood Advances [Elsevier BV]
卷期号:7 (9): 1899-1909 被引量:16
标识
DOI:10.1182/bloodadvances.2022009010
摘要

Abstract Risk stratification in acute myeloid leukemia (AML) remains principle in survival prognostication and treatment selection. The 2022 European LeukemiaNet (ELN) recommendations were recently published, with notable updates to risk group assignment. The complexity of risk stratification and comparative outcomes between the 2022 and 2017 ELN guidelines remains unknown. This comparative analysis evaluated outcomes between the 2017 and 2022 ELN criteria in patients enrolled within the multicenter Beat AML cohort. Five hundred thirteen patients were included. Most patients had 1 or 2 ELN risk–defining abnormalities. In patients with ≥2 ELN risk–defining mutations, 44% (n = 132) had mutations spanning multiple ELN risk categories. Compared with ELN 2017 criteria, the updated ELN 2022 guidelines changed the assigned risk group in 15% of patients, including 10%, 26%, and 6% of patients categorized as being at ELN 2017 favorable–, intermediate–, and adverse–risk, respectively. The median overall survival across ELN 2022 favorable–, intermediate–, and adverse–risk groups was not reached, 16.8, and 9.7 months, respectively. The ELN 2022 guidelines more accurately stratified survival between patients with intermediate- or adverse-risk AML treated with induction chemotherapy compared with ELN 2017 guidelines. The updated ELN 2022 guidelines better stratify survival between patients with intermediate- or adverse-risk AML treated with induction chemotherapy. The increased complexity of risk stratification with inclusion of additional cytogenetic and molecular aberrations necessitates clinical workflows simplifying risk stratification.
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