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Validation of the revised 2022 European LeukemiaNet risk stratification in adult patients with acute myeloid leukemia

In 2022, the European LeukemiaNet (ELN) risk stratification for patients with acute myeloid leukemia (AML) has been updated. We aimed to validate the prognostic value of the 2022 ELN classification (ELN22) by evaluating 1570 patients with newly diagnosed AML (median age, 56 years) treated with cytar...

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Auteurs principaux: Ruhnke, Leo (Auteur) , Bill, Marius (Auteur) , Zukunft, Sven (Auteur) , Eckardt, Jan-Niklas (Auteur) , Schaefer, Silvia (Auteur) , Stasik, Sebastian (Auteur) , Hanoun, Maher (Auteur) , Schroeder, Thomas (Auteur) , Fransecky, Lars (Auteur) , Steffen, Bjoern (Auteur) , Krause, Stefan W. (Auteur) , Scholl, Sebastian (Auteur) , Hochhaus, Andreas (Auteur) , Sauer, Tim (Auteur) , Kraus, Sabrina (Auteur) , Schaefer-Eckart, Kerstin (Auteur) , Kaufmann, Martin (Auteur) , Jost, Edgar (Auteur) , Brümmendorf, Tim Henrik (Auteur) , Schliemann, Christoph (Auteur) , Mikesch, Jan-Henrik (Auteur) , Krug, Utz (Auteur) , Haenel, Mathias (Auteur) , Morgner, Anke (Auteur) , Schaich, Markus (Auteur) , Neubauer, Andreas (Auteur) , Repp, Roland (Auteur) , Niemann, Dirk (Auteur) , Seggewiss-Bernhardt, Ruth (Auteur) , Meinhardt, Achim (Auteur) , Kullmer, Johannes (Auteur) , Kaiser, Ulrich (Auteur) , Blau, Wolfgang (Auteur) , Kiani, Alexander (Auteur) , Grigoleit, Goetz Ulrich (Auteur) , Giagounidis, Aristoteles (Auteur) , Schafer-Eckart, Kerstin (Auteur) , Steffan, Bjorn (Auteur) , Wurm, Alexander A. (Auteur) , Altmann, Heidi (Auteur) , Middeke, Jan Moritz (Auteur) , Schetelig, Johannes (Auteur) , Müller-Tidow, Carsten (Auteur) , Stoelzel, Friedrich (Auteur) , Baldus, Claudia D. (Auteur) , Platzbecker, Uwe (Auteur) , Serve, Hubert (Auteur) , Bornhäuser, Martin (Auteur) , Thiede, Christian (Auteur) , Röllig, Christoph (Auteur)
Format: Article (Journal)
Langue:anglais
Publié: 25 March 2025
In: Blood advances
Year: 2025, Volume: 9, Numéro: 6, Pages: 1392-1404
ISSN:2473-9537
DOI:10.1182/bloodadvances.2024013304
Accès en ligne:Verlag, kostenfrei, Volltext: https://doi.org/10.1182/bloodadvances.2024013304
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S2473952924006438?pes=vor&utm_source=clarivate&getft_integrator=clarivate
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Notes sur l'auteur:Leo Ruhnke, Marius Bill, Sven Zukunft, Jan-Niklas Eckardt, Silvia Schaefer, Sebastian Stasik, Maher Hanoun, Thomas Schroeder, Lars Fransecky, Bjoern Steffen, Stefan W. Krause, Sebastian Scholl, Andreas Hochhaus, Tim Sauer, Sabrina Kraus, Kerstin Schaefer-Eckart, Martin Kaufmann, Edgar Jost, Tim Bruemmendorf, Christoph Schliemann, Jan-Henrik Mikesch, Utz Krug, Mathias Haenel, Anke Morgner, Markus Schaich, Andreas Neubauer, Roland Repp, Dirk Niemann, Ruth Seggewiss-Bernhardt, Achim Meinhardt, Johannes Kullmer, Ulrich Kaiser, Wolfgang Blau, Alexander Kiani, Goetz Ulrich Grigoleit, Aristoteles Giagounidis, Kerstin Schafer-Eckart, Bjorn Steffan, Alexander A. Wurm, Heidi Altmann, Jan Moritz Middeke, Johannes Schetelig, Carsten Mueller-Tidow, Friedrich Stoelzel, Claudia D. Baldus, Uwe Platzbecker, Hubert Serve, Martin Bornhaeuser, Christian Thiede, Christoph Roellig
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Résumé:In 2022, the European LeukemiaNet (ELN) risk stratification for patients with acute myeloid leukemia (AML) has been updated. We aimed to validate the prognostic value of the 2022 ELN classification (ELN22) by evaluating 1570 patients with newly diagnosed AML (median age, 56 years) treated with cytarabine-based intensive chemotherapy regimens. Compared with 2017 ELN classification (ELN17), which allocated 595 (38%), 413 (26%), and 562 patients (36%) to the favorable-, intermediate-, and adverse-risk categories, ELN22 classified 575 (37%), 410 (26%), and 585 patients (37%) as favorable, intermediate, and adverse risk, respectively. Risk group allocation was revised in 340 patients (22%). Most patients were reclassified into the ELN22 intermediate- or ELN22 adverse-risk group. The allocation of patients according to the ELN22 risk categories resulted in a significantly distinct event-free survival (EFS), relapse-free survival, and overall survival (OS). Compared with ELN17, reallocation according to the ELN22 recommendations resulted in a significantly improved prognostic discrimination for OS (3-year area under the curve, 0.71 vs 0.67). In patients with ELN22 favorable-risk AML, co-occurring myelodysplasia-related (MR) gene mutations did not significantly affect outcomes. Within the ELN22 adverse-risk group, we observed marked survival differences across mutational groups (5-year OS rate of 21% and 3% in patients with MR gene mutations and TP53 mutations, respectively). In patients harboring MR gene mutations, EZH2-, STAG2-, and ZRSR2-mutated patients showed an intermediate-like OS. In patients with secondary AML and those who underwent allogeneic hematopoietic cell transplantation, EFS and OS significantly differed between ELN22 risk groups, whereas the prognostic abilities of ELN17 and ELN22 classifications were similar. In conclusion, ELN22 improves prognostic discrimination in a large cohort of intensively treated patients with AML. Given the heterogeneous outcome in patients with MR gene alterations, ranging between those of intermediate and adverse risk patients, we suggest re-evaluation of risk allocation in these patients.
Description:Online verfügbar: 8. November 2024, Artikelversion 25. März 2025
Gesehen am 02.06.2026
Description matérielle:Online Resource
ISSN:2473-9537
DOI:10.1182/bloodadvances.2024013304

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