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.
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