title: A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study.
abstract: A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19-70) receiving a combination of intensive chemotherapy+Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36±4%, respectively. Disease status (relapse <12 months, including refractory patients), FLT3-ITD-positive status and high-risk cytogenetics were the three strongest independent adverse prognostic factors for OS and EFS in this series. We then defined three subgroups with striking different outcomes at 2 years: no adverse factor (favourable, N=36): OS 58%, EFS 45%; one adverse factor (intermediate, N=54): OS 37%, EFS 31%; two or three adverse factors (poor, N=43): OS 12%, EFS 12% (P<10(-4), P=0.001). This new simplified Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.
authors.affiliation: Service d'Hématologie Clinique, CHU and Université de Nantes, INSERM U892, Nantes, France.
authors.forename: P
authors.initials: P
authors.lastname: Chevallier
authors.forename: M
authors.initials: M
authors.lastname: Labopin
authors.forename: P
authors.initials: P
authors.lastname: Turlure
authors.forename: T
authors.initials: T
authors.lastname: Prebet
authors.forename: A
authors.initials: A
authors.lastname: Pigneux
authors.forename: M
authors.initials: M
authors.lastname: Hunault
authors.forename: K
authors.initials: K
authors.lastname: Filanovsky
authors.forename: P
authors.initials: P
authors.lastname: Cornillet-Lefebvre
authors.forename: I
authors.initials: I
authors.lastname: Luquet
authors.forename: L
authors.initials: L
authors.lastname: Lode
authors.forename: S
authors.initials: S
authors.lastname: Richebourg
authors.forename: O
authors.initials: O
authors.lastname: Blanchet
authors.forename: N
authors.initials: N
authors.lastname: Gachard
authors.forename: N
authors.initials: N
authors.lastname: Vey
authors.forename: N
authors.initials: N
authors.lastname: Ifrah
authors.forename: N
authors.initials: N
authors.lastname: Milpied
authors.forename: J-L
authors.initials: JL
authors.lastname: Harousseau
authors.forename: M-C
authors.initials: MC
authors.lastname: Bene
authors.forename: M
authors.initials: M
authors.lastname: Mohty
authors.forename: J
authors.initials: J
authors.lastname: Delaunay
mesh_terms: D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018572:Disease-Free Survival; D000079982:Gemtuzumab; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000617:Aminoglycosides; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000079982:Gemtuzumab