title: Specific scoring systems to predict survival of patients with high-risk myelodysplastic syndrome (MDS) and de novo acute myeloid leukemia (AML) after intensive antileukemic treatment based on results of the EORTC-GIMEMA AML-10 and intergroup CRIANT studies.
abstract: High-risk myelodysplastic syndrome (MDS) patients have usually a less favorable outcome after intensive treatment compared with de novo acute myeloid leukemia (AML) patients. This may reflect different disease-related and patient-related factors. The purpose of this analysis is to identify disease-specific prognostic factors and to develop prognostic scores for both patient groups. A total of 692 patients in the EORTC/GIMEMA AML-10 study and 289 patients in the CRIANT study received identical remission-induction and consolidation treatment. Estimated 5-year survival rate was 34 % in the AML-10 versus 27 % in the CRIANT study, and estimated disease-free survival was 40 % versus 28 %, respectively. In multivariate analysis, cytogenetic characteristics, white blood count, and age appeared prognostic for survival in both studies. French-American-British (FAB) subtype and performance status were prognostic in the AML-10 study only, whereas number of cytopenias and duration of antecedent hematologic disorder >6 months were prognostic in the CRIANT study only. The prognostic scores distinguish three groups with a 5-year survival rate of 54, 38, and 19 % in the AML-10 study versus 69, 37, and 5 % in the CRIANT study. The prognostic value of these scores has been validated on two external series. The new scoring systems form a practical tool to predict the outcome of individual MDS and AML patients treated with intensive antileukemic therapy.
authors.affiliation: Department of Tumor Immunology, Nijmegen Center of Life Sciences, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, Netherlands.
authors.forename: Margriet
authors.initials: M
authors.lastname: Oosterveld
authors.forename: Stefan
authors.initials: S
authors.lastname: Suciu
authors.forename: Petra
authors.initials: P
authors.lastname: Muus
authors.forename: Ulrich
authors.initials: U
authors.lastname: Germing
authors.forename: Michel
authors.initials: M
authors.lastname: Delforge
authors.forename: Amin
authors.initials: A
authors.lastname: Belhabri
authors.forename: Carlo
authors.initials: C
authors.lastname: Aul
authors.forename: Dominik
authors.initials: D
authors.lastname: Selleslag
authors.forename: Augustin
authors.initials: A
authors.lastname: Ferrant
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Marie
authors.forename: Sergio
authors.initials: S
authors.lastname: Amadori
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jehn
authors.forename: Franco
authors.initials: F
authors.lastname: Mandelli
authors.forename: Uwe
authors.initials: U
authors.lastname: Hess
authors.forename: Eva
authors.initials: E
authors.lastname: Hellström-Lindberg
authors.forename: Songuel
authors.initials: S
authors.lastname: Cakmak-Wollgast
authors.forename: Marco
authors.initials: M
authors.lastname: Vignetti
authors.forename: Boris
authors.initials: B
authors.lastname: Labar
authors.forename: Roel
authors.initials: R
authors.lastname: Willemze
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000175:diagnosis* / Q000401:mortality*; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult