Haferlach et al developed a new prognostic score for patients with acute myeloid leukemia (AML). This can help identify patients who may require more aggressive management. The authors are from the German AML Cooperative Group.
Patient selection: de novo diagnosis of AML and age > 16 years
Parameters:
(1) prognostic group based on cytogenetics
(2) bone marrow blasts on day 16 after starting therapy
Cytogenetic Findings
Prognostic Group
t(8;21) or t(16;16) or inv(16)
favorable
normal or not in favorable or unfavorable group
intermediate
aberrations in chromosome 5, chromosome 7, 11q23, 12p, or 17p
unfavorable
inv(3) or t(3;3)
unfavorable
>=3 chromosomes involved (complex aberrant)
unfavorable
Prognostic Group
Bone Marrow Blasts
Group
favorable
1
intermediate
< 10%
2
intermediate
>= 10%
3
unfavorable (not complex aberrant)
4
unfavorable (complex aberrant)
5
Group
Median Overall Survival from 1999 Study
Complete Response to Therapy
1
25 months
63%
2
15 months
65%
3
12 months
51%
4
6 months
45%
5
4 months
35%
where:
• The overall survival data makes merging Groups 2+3 and 4+5 attractive.
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