Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial.
Patients with secondary acute myeloid leukemia (sAML) are generally thought to have a poor prognosis. As there are no prognostic risk stratification models for patients with sAML available, the aim of this study was to obtain a scoring system. Prognostic factors influencing overall survival (OS) and event-free survival (EFS) were analyzed in 305 sAML patients treated in the prospective AML96 trial. The obtained prognostic scoring system was then validated in an independent patient cohort included in the AML2003 and AML60+ trials. In addition to the known risk factors for AML, age and karyotype, we identified the absolute platelet count and the Nucleophosmin 1 mutational status at diagnosis as prognostic factors of sAML patients. A pronounced distribution of sAML patients into three score groups was achieved showing a 2-year OS/EFS of 52/44% for patients in the low-risk group, 21/12% in the intermediate-risk group and 7/3% in the high-risk group (both P<0.001). Validation of this scoring system in a second independent set of sAML patients revealed similar significantly different survival results. In conclusion, for the first time, a prognostic scoring system is provided for sAML patients, allowing differential treatment strategies in the future.
Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany. friedrich.stoelzel@uniklinikum-dresden.de
F
F
Stölzel
M
M
Pfirrmann
W E
WE
Aulitzky
M
M
Kaufmann
H
H
Bodenstein
M
M
Bornhäuser
C
C
Röllig
M
M
Kramer
B
B
Mohr
U
U
Oelschlägel
N
N
Schmitz
S
S
Soucek
C
C
Thiede
G
G
Ehninger
M
M
Schaich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016609:Neoplasms, Second Primary / Q000235:genetics / Q000401:mortality*; D009687:Nuclear Proteins / Q000235:genetics; D000090243:Nucleophosmin; D010976:Platelet Count; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D016896:Treatment Outcome
C000716967:NPM1 protein, human; D009687:Nuclear Proteins; D000090243:Nucleophosmin