Prognostic analysis according to European LeukemiaNet 2022 risk stratification for elderly patients with acute myeloid leukemia treated with decitabine.

IF 2 4区 医学 Q3 HEMATOLOGY Hematology Pub Date : 2024-12-01 Epub Date: 2024-03-03 DOI:10.1080/16078454.2024.2324417
Mihee Kim, Seo-Yeon Ahn, TaeHyung Kim, Sung-Hoon Jung, Ga-Young Song, Deok-Hwan Yang, Je-Jung Lee, Mi Yeon Kim, Ju Heon Park, Myung-Geun Shin, Jae-Sook Ahn, Hyeoung-Joon Kim, Dennis Dong Hwan Kim
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Abstract

Objectives: This study aimed to evaluate the prognostic significance of the revised European LeukemiaNet (ELN)-2022 risk stratification model for 123 elderly acute myeloid leukemia (AML) patients treated with decitabine chemotherapy.

Results: Based on the ELN-2022 risk stratification, 15 (12.2%), 51 (41.5%), and 57 (46.3%) patients were classified as having favorable, intermediate, and high-risk AML, respectively. In comparison with the ELN-2017 risk stratification, the ELN-2022 risk stratification re-assigned 26 (21.1%) and three (2.4%) patients to the adverse and favorable risk groups, respectively. Survival analysis revealed distinctive overall survival (OS) outcomes among the ELN-2022 risk groups (6-month OS rate: 73.3%, 52.9%, and 47.7% for favorable, intermediate, and adverse risk, respectively; P = 0.101), with a parallel trend observed in the event-free survival (EFS) (6-month EFS rate: 73.3%, 52.9%, and 45.6% for favorable, intermediate, and adverse risk, respectively; P = 0.049). Notably, both OS and EFS in the favorable risk group were significantly superior in comparison to that of the adverse risk group (OS: P = 0.040, EFS: P = 0.030). Although the ELN-2022 C-index (0.559) was greater than the ELN-2017 C-index (0.539), the result was not statistically significant (P = 0.059). Based on the event net reclassification index, we consistently observed significant improvements in the ELN-2022 risk stratification for overall survival (0.21 at 6 months).

Conclusion: In conclusion, the revised ELN-2022 risk stratification model may have improved the risk classification of elderly AML patients treated with hypomethylating agents compared to the ELN-2017 risk stratification model.

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根据欧洲白血病网络 2022 对接受地西他滨治疗的老年急性髓性白血病患者进行风险分层的预后分析。
研究目的本研究旨在评估修订后的欧洲白血病网络(ELN)-2022风险分层模型对123名接受地西他滨化疗的老年急性髓性白血病(AML)患者的预后意义:根据ELN-2022风险分层,分别有15例(12.2%)、51例(41.5%)和57例(46.3%)患者被归类为有利、中度和高风险急性髓细胞白血病。与ELN-2017风险分层相比,ELN-2022风险分层分别将26例(21.1%)和3例(2.4%)患者重新划分为不良风险组和良好风险组。生存期分析显示,ELN-2022 风险组的总生存期(OS)结果各不相同(6 个月 OS 率:73.3%、52.9%、52.9%):良好风险组、中等风险组和不良风险组的 6 个月 OS 率分别为 73.3%、52.9% 和 47.7%;P = 0.101),无事件生存期(EFS)方面也观察到类似趋势(6 个月 EFS 率分别为 73.3%、52.9% 和 47.7%;P = 0.101):在无事件生存期(EFS)方面也观察到平行趋势(6 个月的 EFS 率:良好风险、中等风险和不良风险分别为 73.3%、52.9% 和 45.6%;P = 0.049)。值得注意的是,与不良风险组相比,良好风险组的 OS 和 EFS 均明显优于不良风险组(OS:P = 0.040,EFS:P = 0.030)。虽然ELN-2022的C指数(0.559)大于ELN-2017的C指数(0.539),但结果无统计学意义(P = 0.059)。根据事件净重分类指数,我们持续观察到ELN-2022总生存期风险分层有显著改善(6个月时为0.21):总之,与 ELN-2017 风险分层模型相比,修订后的 ELN-2022 风险分层模型可能改善了接受低甲基化药物治疗的老年 AML 患者的风险分级。
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来源期刊
Hematology
Hematology 医学-血液学
CiteScore
2.60
自引率
5.30%
发文量
140
审稿时长
3 months
期刊介绍: Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.
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