Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Jeollanam-do, Republic of Korea.
Department of Computer Science, University of Toronto, Toronto, Canada.
Hematology. 2024 Dec;29(1):2324417. doi: 10.1080/16078454.2024.2324417. Epub 2024 Mar 3.
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.
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; = 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; = 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: = 0.040, EFS: = 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 ( = 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).
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.
本研究旨在评估修订后的欧洲白血病网（ELN）-2022 风险分层模型对 123 例接受地西他滨化疗的老年急性髓系白血病（AML）患者的预后意义。
根据 ELN-2022 风险分层，15 例（12.2%）、51 例（41.5%）和 57 例（46.3%）患者分别被归类为低危、中危和高危 AML。与 ELN-2017 风险分层相比，ELN-2022 风险分层将 26 例（21.1%）和 3 例（2.4%）患者重新分配到不良风险和有利风险组。生存分析显示，ELN-2022 风险组之间具有明显的总生存（OS）结果（6 个月 OS 率：低危、中危和高危分别为 73.3%、52.9%和 47.7%；=0.101），无事件生存（EFS）也呈现出类似的趋势（6 个月 EFS 率：低危、中危和高危分别为 73.3%、52.9%和 45.6%；=0.049）。值得注意的是，与高危组相比，低危组的 OS 和 EFS 均显著提高（OS：=0.040，EFS：=0.030）。尽管 ELN-2022 C 指数（0.559）大于 ELN-2017 C 指数（0.539），但差异无统计学意义（=0.059）。基于事件净重新分类指数，我们始终观察到 ELN-2022 风险分层对总体生存的显著改善（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剂治疗的老年 AML 患者的风险分类。
