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% |
Purpose: To evaluate an adult with acute myelogenous leukemia (AML) in a first relapse using the prognostic index of Breems et al.
Specialty: Hematology Oncology
Objective: risk factors, severity, prognosis, stage, complications, selection
ICD-10: C92,