Prognostic index for adult patients with acute myeloid leukemia in first relapse
Prognostic index for adult patients with acute myeloid leukemia in first relapse
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DOI：
10.1200/jco.2005.06.027
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发表时间：
2005-03-20
影响因子：
45.3
通讯作者：
Löwenberg, B
中科院分区：
文献类型：
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作者：
Breems, DA;Van Putten, WLJ;Löwenberg, B
目的首次复发的急性髓系白血病(AML)的治疗与完全应答率不满意有关，而完全应答率通常很短。因此，临床上有用的预后指标可以促进AML复发时的治疗决策和研究治疗策略的评估。患者和方法对1540例新诊断的非M3型AML患者(年龄15~60岁)中667例首次复发的AML患者进行多因素分析，得出预后评分。根据这一分层系统，定义了三个危险组：预后良好的A组(1年总生存率为70%，5年总生存率为46%)，中危B组(1年总生存率为49%，5年总生存率为18%)，以及不良风险组(1年总生存率为16%，5年总生存率为4%)。结论预后指数可以用4个常用的临床参数来评估AML患者首次复发的预后，并可确定哪些患者适合挽救和调查治疗。(C)2005年，由美国临床肿瘤学会提供。
Purpose The treatment of acute myeloid leukemia (AML) in first relapse is associated with unsatisfactory rates of complete responses that usually are short lived. Therefore, a clinically useful prognostic index can facilitate therapeutic decision making and evaluation of investigational treatment strategies at relapse of AML. Patients andMethods A prognostic score is presented based on the multivariate analysis of 667 AML patients in first relapse among 1,540 newly diagnosed non-M3 AML patients (age 15 to 60 years) entered onto three successive Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group trials.Results Four clinically relevant parameters are included in this index (ie, length of relapse-free interval after first complete remission, cytogenetics at diagnosis, age at relapse, and whether previous stem-cell transplantation was performed). Using this stratification system, three risk groups were defined: a favorable prognostic group A (overall survival [OS] of 70% at 1 year and 46% at 5 years), an intermediate-risk group B (CS of 49% at 1 year and 18% at 5 years), and a poor-risk group C (OS of 16% at 1 year and 4% at 5 years).Conclusion The prognostic index estimates the outcome of AML patients in first relapse using four commonly applied clinical parameters and might identify patients who are candidates for salvage and investigational therapy. (c) 2005 by American Society of Clinical Oncology.