TY - JOUR
T1 - Outcome prediction by the 2022 European LeukemiaNet genetic-risk classification for adults with acute myeloid leukemia
T2 - an Alliance study
AU - Mrózek, Krzysztof
AU - Kohlschmidt, Jessica
AU - Blachly, James S.
AU - Nicolet, Deedra
AU - Carroll, Andrew J.
AU - Archer, Kellie J.
AU - Mims, Alice S.
AU - Larkin, Karilyn T.
AU - Orwick, Shelley
AU - Oakes, Christopher C.
AU - Kolitz, Jonathan E.
AU - Powell, Bayard L.
AU - Blum, William G.
AU - Marcucci, Guido
AU - Baer, Maria R.
AU - Uy, Geoffrey L.
AU - Stock, Wendy
AU - Byrd, John C.
AU - Eisfeld, Ann Kathrin
N1 - Funding Information:
Celebrating the life and accomplishments of Dr. Clara D. Bloomfield (1942–2020), who died unexpectedly on March 1, 2020. The authors are grateful to the patients who consented to participate in these clinical trials and the families who supported them; to Christopher Manring and the CALGB/Alliance Leukemia Tissue Bank at The Ohio State University Comprehensive Cancer Center, Columbus, OH, for sample processing and storage services; and to Lisa J. Sterling for data management. Research reported in this publication was supported by an allocation of computing resources from The Ohio Supercomputer Center and Shared Resources (Leukemia Tissue Bank). Research reported in this publication was supported in part by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180821, U10CA180882, and U24CA196171 (to the Alliance for Clinical Trials in Oncology), UG1CA189824, UG1CA233338, UG1CA233339, P50 CA140158, UG1CA233331, R35CA197734, UG1CA189850, UG1CA233180, UG1CA233327, and 5P30CA016058; the Coleman Leukemia Research Foundation; ASH Junior Faculty Scholar and ASH Bridge Award (A-KE); the Leukemia & Lymphoma Society Translational Research Grant (A-KE); The Leukemia Research Foundation (A-KE); the National Comprehensive Cancer Network Foundation Young Investigator Award (JSB); the Alliance for Clinical Trials in Oncology Scholar Award (JSB); The D Warren Brown Foundation; Pelotonia (A-KE, ASM). Support to Alliance for Clinical Trials in Oncology and Alliance Foundation Trials programs is listed at https://acknowledgments.alliancefound.org . Trial Registration Numbers are NCT00048958, NCT00899223, NCT00900224. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Celebrating the life and accomplishments of Dr. Clara D. Bloomfield (1942–2020), who died unexpectedly on March 1, 2020. The authors are grateful to the patients who consented to participate in these clinical trials and the families who supported them; to Christopher Manring and the CALGB/Alliance Leukemia Tissue Bank at The Ohio State University Comprehensive Cancer Center, Columbus, OH, for sample processing and storage services; and to Lisa J. Sterling for data management. Research reported in this publication was supported by an allocation of computing resources from The Ohio Supercomputer Center and Shared Resources (Leukemia Tissue Bank). Research reported in this publication was supported in part by the National Cancer Institute of the National Institutes of Health under Award Numbers U10CA180821, U10CA180882, and U24CA196171 (to the Alliance for Clinical Trials in Oncology), UG1CA189824, UG1CA233338, UG1CA233339, P50 CA140158, UG1CA233331, R35CA197734, UG1CA189850, UG1CA233180, UG1CA233327, and 5P30CA016058; the Coleman Leukemia Research Foundation; ASH Junior Faculty Scholar and ASH Bridge Award (A-KE); the Leukemia & Lymphoma Society Translational Research Grant (A-KE); The Leukemia Research Foundation (A-KE); the National Comprehensive Cancer Network Foundation Young Investigator Award (JSB); the Alliance for Clinical Trials in Oncology Scholar Award (JSB); The D Warren Brown Foundation; Pelotonia (A-KE, ASM). Support to Alliance for Clinical Trials in Oncology and Alliance Foundation Trials programs is listed at https://acknowledgments.alliancefound.org. Trial Registration Numbers are NCT00048958, NCT00899223, NCT00900224. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/4
Y1 - 2023/4
N2 - Recently, the European LeukemiaNet (ELN) revised its genetic-risk classification of acute myeloid leukemia (AML). We categorized 1637 adults with AML treated with cytarabine/anthracycline regimens according to the 2022 and 2017 ELN classifications. Compared with the 2017 ELN classification, 2022 favorable group decreased from 40% to 35% and adverse group increased from 37% to 41% of patients. The 2022 genetic-risk groups seemed to accurately reflect treatment outcomes in all patients and patients aged <60 years, but in patients aged ≥60 years, relapse rates, disease-free (DFS) and overall (OS) survival were not significantly different between intermediate and adverse groups. In younger African-American patients, DFS and OS did not differ between intermediate-risk and adverse-risk patients nor did DFS between favorable and intermediate groups. In Hispanic patients, DFS and OS did not differ between favorable and intermediate groups. Outcome prediction abilities of 2022 and 2017 ELN classifications were similar. Among favorable-risk patients, myelodysplasia-related mutations did not affect patients with CEBPAbZIP mutations or core-binding factor AML, but changed risk assignment of NPM1-mutated/FLT3-ITD-negative patients to intermediate. NPM1-mutated patients with adverse-risk cytogenetic abnormalities were closer prognostically to the intermediate than adverse group. Our analyses both confirm and challenge prognostic significance of some of the newly added markers.
AB - Recently, the European LeukemiaNet (ELN) revised its genetic-risk classification of acute myeloid leukemia (AML). We categorized 1637 adults with AML treated with cytarabine/anthracycline regimens according to the 2022 and 2017 ELN classifications. Compared with the 2017 ELN classification, 2022 favorable group decreased from 40% to 35% and adverse group increased from 37% to 41% of patients. The 2022 genetic-risk groups seemed to accurately reflect treatment outcomes in all patients and patients aged <60 years, but in patients aged ≥60 years, relapse rates, disease-free (DFS) and overall (OS) survival were not significantly different between intermediate and adverse groups. In younger African-American patients, DFS and OS did not differ between intermediate-risk and adverse-risk patients nor did DFS between favorable and intermediate groups. In Hispanic patients, DFS and OS did not differ between favorable and intermediate groups. Outcome prediction abilities of 2022 and 2017 ELN classifications were similar. Among favorable-risk patients, myelodysplasia-related mutations did not affect patients with CEBPAbZIP mutations or core-binding factor AML, but changed risk assignment of NPM1-mutated/FLT3-ITD-negative patients to intermediate. NPM1-mutated patients with adverse-risk cytogenetic abnormalities were closer prognostically to the intermediate than adverse group. Our analyses both confirm and challenge prognostic significance of some of the newly added markers.
UR - http://www.scopus.com/inward/record.url?scp=85148650192&partnerID=8YFLogxK
U2 - 10.1038/s41375-023-01846-8
DO - 10.1038/s41375-023-01846-8
M3 - Article
C2 - 36823396
AN - SCOPUS:85148650192
SN - 0887-6924
VL - 37
SP - 788
EP - 798
JO - Leukemia
JF - Leukemia
IS - 4
ER -