The prognosis for a patient with acute myeloid leukemia can be predicted from genetic studies based on the European LeukemiaNet classification.
Patient selection: acute myeloid leukemia
Parameters:
(1) karyotype
(2) mutation
Prognostic Groups:
(1) favorable
(2) intermediate-I
(3) intermediate-II
(4) adverse
Normal Karyotype
Mutation
Prognostic Group
wild type NPM1, with FLT3-ITD
intermediate-1
wild type NPM1, without FLT3-ITD
mutated NPM1, with FLT3-ITD
mutated NPM1, without FLT3-ITD
favorable
mutated CEBPA
Abnormal Karyotype
Cytogenetics
Gene Name
Prognosis
t(8;21)(q22;q22)
RUNX1-RUNX1T1
inv(16)(p13.1;q22) or t(16;16)(p13.1;q22)
CBFB-MYH11
t(9;11)(p22;q23)
MLLT3-MLL
intermediate-2
inv(3)(q21q26.2) or t(3;3)(q21;q26.2)
RPN1-EV11
adverse
t(6;9)(p23;q23)
DEK-NUP214
t(v;11)(v;q23)
MLL rearranged
-5 or del(5q)
-7
abnormal 17p
complex (see below)
Any other cytogenetic abnormality is classified as intermediate-2.
Complex cytogenetics involves:
(1) 3 or more cytogenetic abnormalities
(2) absence of WHO designated recurring translocations or inversions = t(15;17), t(8;21), inv(16), t(16;16), t(9;11), t(v11)(v;q23), t(6;9), inv3, t(3;3)
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Specialty: Hematology Oncology
