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Prognostic Index of Breems et al (European Prognostic Score) for an Adult Patient with Acute Myelogenous Leukemia (AML) in the First Relapse

Purpose: To evaluate an adult with acute myelogenous leukemia (AML) in a first relapse using the prognostic index of Breems et al.

Description

Breems et al developed a prognostic index for a patient with acute myelogenous leukemia having a first relapse. This can help identify patients who may require more aggressive management. The authors are from the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON) and the Swiss Group for Clinical Cancer Research Collaborative Group (SAKK).


Patient selection: ages 15 to 60 years of age with AML

 

Parameters:

(1) age of the patient at first relapse in years

(2) duration of the first relapse free period in months

(3) cytogenetic abnormalities at diagnosis

(4) stem cell transplantation

 

Parameter

Finding

Points

age of the patient at first relapse

<= 35 years of age

0

 

36 - 45 years of age

1

 

>= 46 years of age

2

duration of first relapse free period

<= 6 months

5

 

7 - 18 months

3

 

> 18 months

0

cytogenetic abnormalities

t(16;16) with or without additional abnormalities

0

 

inv(16) with or without additional abnormalities

0

 

t(8;21)

3

 

normal

5

 

other (intermediate risk, unfavorable, unknown)

5

stem cell transplantation

previous autologous

2

 

previous allogeneic

2

 

none

0

 

prognostic index =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum index: 0

• maximum index: 14

• The higher the index the worse prognosis.

 

Total Index

Prognosis

1 Year Overall Survival

5 Year Overall Survival

1 to 6

favorable

70%

46%

7 to 9

intermediate

49%

18%

10 to 14

poor

16%

4%

 


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Specialty

Objective

ICD-10