Li et al reported a prognostic model for pediatric patients with acute myeloid leukemia (AML). This can help to guide management according to risk. The authors are from the Chinese Academy of Medical Sciences and Peking Union Medical College in Tianjin, China.
Patient selection: pediatric patient with AML
Parameters:
(1) -7/del(7q)
(2) -5/del(5q)
(3) CBF fusion gene
(4) FLT3-ITD
(5) NPM1
(6) biallelic mutation in CEBPA
(7) WT1 mutation
(8) age at diagnosis
Parameter |
Finding |
Points |
CBF fusion gene |
no |
0 |
|
yes |
-1.452 |
CEPBA biallelic mutation |
no |
0 |
|
yes |
-1.166 |
WT1 mutation |
no |
0 |
|
yes |
0.553 |
age at diagnosis |
< 2 years |
0 |
|
>= 2 years |
0.380 |
-7/del(7q) |
-5/del(5q) |
Points |
no |
no |
0 |
yes |
no |
0.862 |
no |
yes |
0.862 |
yes |
yes |
0.862 |
FLT3-ITD |
NPM1 |
Points |
yes |
no |
0.054 |
no |
yes |
-1.252 |
yes |
yes |
-0.512 |
no |
no |
0 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: -3.87
• maximum score: 1.849
• A high-risk patient is a candidate for more aggressive management including hematopoietic stem cell transplantation.
Score |
Risk Category |
5-Year Overall Survival |
< -1.018 |
low |
86% |
-1.018 to 0.380 |
intermediate |
67% |
> 0.380 |
high |
37% |
Performance:
• The area under the ROC curve is 0.68.
Specialty: Hematology Oncology