https://scholars.lib.ntu.edu.tw/handle/123456789/631150
標題: | Validation of the prognostic significance of the 2022 European LeukemiaNet risk stratification system in intensive chemotherapy treated aged 18 to 65 years patients with de novo acute myeloid leukemia | 作者: | Lo, Min-Yen Tsai, Xavier Cheng-Hong CHIEN-CHIN LIN FENG-MING TIEN Kuo, Yuan-Yeh WAN-HSUAN LEE Peng, Yen-Ling Liu, Ming-Chih Tseng, Mei-Hsuan Hsu, Cheng-An JUI-CHE CHEN LIANG-IN LIN Sun, Hsun-I Chuang, Yi-Kuang BOR-SHENG KO JIH-LUH TANG MING YAO WEN-CHIEN CHOU HSIN-AN HOU HWEI-FANG TIEN |
關鍵字: | HEALTH-ORGANIZATION CLASSIFICATION; DNMT3A MUTATIONS; AML; T(7/11)(P15,P15); RECOMMENDATIONS; MANAGEMENT; DIAGNOSIS | 公開日期: | 五月-2023 | 出版社: | WILEY | 卷: | 98 | 期: | 5 | 起(迄)頁: | 760 | 來源出版物: | American journal of hematology | 摘要: | The European LeukemiaNet (ELN) recently proposed a revised recommendation for the diagnosis and management of acute myeloid leukemia (AML) in adults, recognized as ELN-2022. However, validation in a large real-world cohort remains lacking. In this study, we aimed to validate the prognostic relevance of the ELN-2022 in a cohort of 809 de novo, non-M3, younger (ages 18-65 years) AML patients receiving standard chemotherapy. The risk categories of 106 (13.1%) patients were reclassified from that determined using ELN-2017 to that determined using ELN-2022. The ELN-2022 effectively helped distinguish patients as favorable, intermediate, and adverse risk groups in terms of remission rates and survival. Among patients who achieved first complete remission (CR1), allogeneic transplantation was beneficial for those in the intermediate risk group, but not for those in the favorable or adverse risk groups. We further refined the ELN-2022 system by re-categorizing AML patients with t(8;21)(q22;q22.1)/RUNX1::RUNX1T1 with KIThigh , JAK2 or FLT3-ITDhigh mutations into the intermediate risk subset, AML patients with t(7;11)(p15;p15)/NUP98::HOXA9 and AML patients with co-mutated DNMT3A and FLT3-ITD into the adverse risk subsets, and AML patients with complex or monosomal karyotypes, inv (3)(q21.3q26.2) or t(3;3)(q21.3;q26.2)/GATA2,MECOM(EVI1) or TP53 mutation into the very adverse risk subset. The refined ELN-2022 system performed effectively to distinguish patients as favorable, intermediate, adverse, and very adverse risk groups. In conclusion, the ELN-2022 helped distinguish younger, intensively treated patients into three groups with distinct outcomes; the proposed refinement of ELN-2022 may further improve risk stratification among AML patients. Prospective validation of the new predictive model is necessary. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/631150 | ISSN: | 0361-8609 | DOI: | 10.1002/ajh.26892 |
顯示於: | 醫學院附設癌醫中心醫院(臺大癌醫) |
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