Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial

Stölzel, Friedrich; Pfirrmann, Markus; Aulitzky, Walter E.; Kaufmann, Martin; Bodenstein, H.; Bornhäuser, Martin; Röllig, Christoph; Kramer, Michael; Mohr, Brigitte; Oelschlägel, Uta; Schmitz, Norbert; Soucek, Silke; Thiede, Christian; Ehninger, Gerhard; Schaich, Markus

doi:10.1038/leu.2010.279

Cited by 29 publications

(23 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The high median age of 71 years in this study demonstrate its true population-based nature with a median age substantially higher when compared with previous reports on secondary AML [2,6,8,18,19]. The proportion of patients with secondary AML found in our study (26.4%) was also higher compared to most previous studies [3,[20][21][22].…”

Section: Discussioncontrasting

confidence: 66%

“…Although secondary AML has been associated with poor response to standard chemotherapy as well as poor survival, it is still debated whether secondary AML is an independent prognostic factor [4][5][6]. This is due to the fact that secondary AML is associated to factors that confer a poor prognosis such as high age and high-risk cytogenetics [2,7,8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry

et al. 2015

View full text Add to dashboard Cite

Patients with secondary acute myeloid leukemia (AML) often escape inclusion in clinical trials and thus, population-based studies are crucial for its accurate characterization. In this first large population-based study on secondary AML, we studied AML with an antecedent hematological disease (AHD-AML) or therapyrelated AML (t-AML) in the population-based Swedish Acute Leukemia Registry. The study included 3,363 adult patients of which 2,474 (73.6%) had de novo AML, 630 (18.7%) AHD-AML, and 259 (7.7%) t-AML. Secondary AML differed significantly compared to de novo AML with respect to age, gender, and cytogenetic risk. Complete remission (CR) rates were significantly lower but early death rates similar in secondary AML. In a multivariable analysis, AHD-AML (HR 1.51; 95% CI 1.26-1.79) and t-AML (1.72; 1.38-2.15) were independent risk factors for poor survival. The negative impact of AHD-AML and t-AML on survival was highly age dependent with a considerable impact in younger patients, but without independent prognostic value in the elderly. Although patients with secondary leukemia did poorly with intensive treatment, early death rates and survival were significantly worse with palliative treatment. We conclude that secondary AML in a population-based setting has a striking impact on survival in younger AML patients, whereas it lacks prognostic value among the elderly patients.

show abstract

Section: Discussioncontrasting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry

et al. 2015

View full text Add to dashboard Cite

show abstract

“…High-risk AML was defined on the basis of cytogenetics, FLT3-ITD mutation status and blast clearance in the bone marrow on day 15 after initiation of induction chemotherapy as described recently. 10 Therefore, of the 65 high-risk patients, 47 were primary refractory to induction chemotherapy and 18 patients were transplanted during chemotherapy-induced aplasia due to high-risk genetic features. Previously untreated patients were not included in this analysis.…”

mentioning

confidence: 99%

“…8,10 The genomic region of the SETBP1 gene, containing codons 858 to 871 with the mutational hotspots D868 and G870 in the SKI-homologous region, was amplified using PCR. Sequences of the primers were: Forward 5 0 -ACCAAAACCCAAAAGGGAAT-3 0 , and reverse 5 0 -CGGTT TTGCAGGCTTTTC-3 0 .…”

mentioning

confidence: 99%

Early intervention with allogeneic hematopoietic cell transplantation during chemotherapy-induced aplasia in patients with high-risk acute myeloid leukemia

et al. 2013

Self Cite

View full text Add to dashboard Cite

result of the deletions resulting from these rearrangements, clonal B cells or plasma cells will have unique patterns of deletion in the V H yD H yJ H region of the IgH loci. At later stages of B-cell development, IgH switch recombination can reposition the V H D H J H sequence near downstream constant regions (C H ). As a result, clonal B cells or plasma cells that have undergone IgH switch recombination also will have clonal patterns of deletion in the C H region of the IgH locus. Often the B-cell specific deletions described above are large enough to be detected as a homozygous copy number loss using comparative genomic hybridization or single-nucleotide polymorphism arrays. Therefore, copy number changes in the IgH locus have the potential to provide a measure of contamination of clonal B or plasma cells with other cells.Recently, Lopez-Corral et al.2 reported increasing DNA copy number changes detectable in samples from patients with premalignant monoclonal gammopathy of undetermined significance (MGUS) to smoldering multiple myeloma (SMM) to multiple myeloma (MM). As shown in Figure 1a, the inability to detect homozygous, or near-homozygous, deletions within the D H -J H -C H region indicates that substantially more germline D H -J H -C H was detected in the MGUS than in SMM or MM samples they analyzed, indicative of the presence of contaminating DNA from non-tumor cells. This indicates that the purity estimate of their CD138-selected cells (SMM and MM 495%, and MGUS 490%) is inaccurate, particularly for MGUS samples. The extent of this contaminating DNA correlates with the inability to detect whole-genome changes in many MGUS samples (Figure 1b). Therefore, their detection of increasing genomic changes between MGUS, SMM and MM likely relates more to the increasing purity of the samples than to underlying genetic differences between these diseases.Isolation of tumor cells from bone marrow aspirates of patients with MM can achieve a purity of 90-95% by bead selection of cells expressing CD138. However, as the fraction of tumor cells from bone marrow aspirates of patients with MGUS can be 1-2 logs lower than for MM, substantial contamination of purified MGUS tumor cells with non-tumor cells is a significant problem that needs to be rigorously addressed when analyzing purified tumor cells.

show abstract

“…‡ ‡ In some reports of AL, the platelet count, § § hemoglobin level, 30,116,117 and the percentage of blasts 14,103 were also independent, significant factors in OS and EFS.…”

mentioning

confidence: 99%

Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

Arber¹,

Borowitz²,

Cessna³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Context.-A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia.Objective.-To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage.Design.-The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus.Results.-Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported.Conclusions.-The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.

show abstract

Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial

Cited by 29 publications

References 36 publications

Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry

Characterization and prognostic features of secondary acute myeloid leukemia in a population‐based setting: A report from the Swedish Acute Leukemia Registry

Early intervention with allogeneic hematopoietic cell transplantation during chemotherapy-induced aplasia in patients with high-risk acute myeloid leukemia

Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

Contact Info

Product

Resources

About