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Acute Leukemias

Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial

Leukemia volume 25, pages 420–428 (2011)Cite this article

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Abstract

Patients with secondary acute myeloid leukemia (sAML) are generally thought to have a poor prognosis. As there are no prognostic risk stratification models for patients with sAML available, the aim of this study was to obtain a scoring system. Prognostic factors influencing overall survival (OS) and event-free survival (EFS) were analyzed in 305 sAML patients treated in the prospective AML96 trial. The obtained prognostic scoring system was then validated in an independent patient cohort included in the AML2003 and AML60+ trials. In addition to the known risk factors for AML, age and karyotype, we identified the absolute platelet count and the Nucleophosmin 1 mutational status at diagnosis as prognostic factors of sAML patients. A pronounced distribution of sAML patients into three score groups was achieved showing a 2-year OS/EFS of 52/44% for patients in the low-risk group, 21/12% in the intermediate-risk group and 7/3% in the high-risk group (both P<0.001). Validation of this scoring system in a second independent set of sAML patients revealed similar significantly different survival results. In conclusion, for the first time, a prognostic scoring system is provided for sAML patients, allowing differential treatment strategies in the future.

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Acknowledgements

The contribution of all the patients and physicians in the various trials of the German Study Alliance Leukemia (SAL) is highly appreciated. Supported in part by a grant from the ‘Deutsche Krebshilfe e.V.’, Bonn, Germany, Grant No. 70-2210-Eh5.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Dresden, Germany

    F Stölzel, M Bornhäuser, C Röllig, M Kramer, B Mohr, U Oelschlägel, S Soucek, C Thiede, G Ehninger & M Schaich

  2. Department of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich, Germany

    M Pfirrmann

  3. Department of Internal Medicine II, Robert Bosch Hospital, Stuttgart, Germany

    W E Aulitzky & M Kaufmann

  4. Department of Hematology/Oncology, Klinikum Minden, Minden, Germany

    H Bodenstein

  5. Department of Hematology and Stem Cell Transplantation, Asklepios Hospital St. Georg, Hamburg, Germany

    N Schmitz

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Correspondence to F Stölzel.

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Additional information

This study has been presented in part at the 51st Annual Meeting of the American Society of Hematology, 5–8 December 2009, New Orleans, Louisiana, USA.

Supplementary Information accompanies the paper on the Leukemia website

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Appendix

Appendix

List of participating centers and physicians of the Study Alliance Leukemia (SAL)

D Huhn and O Knigge (Universitätsklinikum Charité, Campus Virchow, Berlin); E Spaeth-Schwalbe and S Hesse-Amojo (Krankenhaus Spandau, Berlin); O Rick and W Siegert (Charité Campus Mitte, Berlin); E Thiel and L Uharek (Universitätsklinikum Charité, Campus Benjamin-Franklin, Berlin); R Kolloch and U Krümpelmann (Krankenanstalten Gilead, Bielefeld); K-H Pflueger and T Wolff (Evang Diakonissenanstalt Bremen); H-H Heidtmann (St Joseph-Hospital, Bremerhaven); F Marquard (Allgemeines Krankenhaus, Celle); M Hänel, F Fiedler and R Herbst (Krankenhaus Küchwald, Chemnitz); M Gramatzki and G Helm (Universitätsklinikum, Erlangen); J-G Saal (Malteser Krankenhaus, Flensburg); H-G Hoeffkes and M Arland (Städtisches Klinikum, Fulda); E Fasshauer (St Elisabeth-Krankenhaus, Halle); R Stuhlmann (Asklepios Krankenhaus St Georg, Hamburg); H Schmidt and K Buhrmann (Kreiskrankenhaus, Hameln); H Duerk (St Marien-Hospital, Hamm); M Burk (Klinikum Stadt, Hanau); A-D Ho and U Mahlknecht (Universitätsklinikum, Heidelberg); A Bartholomaeus (St Bernward Krankenhaus, Hildesheim); AA Fauser (Klinik f Hämatologie/Onkologie und KMT, Idar-Oberstein); H Link and F-G Hagmann (Westpfalzklinikum, Kaiserslautern); G Koechling (Kreiskrankenhaus, Leer); K-P Schalk (St Vincent-Krankenhaus, Limburg/Lahn); S Fetscher (Städtisches Krankenhaus Süd, Lübeck); T Wagner (Universitätsklinikum, Lübeck); A Neubauer (Universitätsklinikum, Marburg); J Tischler (Klinikum Minden, Minden); H Pohlmann and N Brack (Städtisches Krankenhaus München Harlaching, München); M Wilhelm, H Wandt and K Schaefer-Eckart, (Städtisches Klinikum, Nürnberg); B Seeber (Klinikum Offenbach, Offenbach); F Hirsch (Kreiskrankenhaus Offenburg, Offenburg); T Geer and H Heissmeyer (Diakonie-Krankenhaus, Schwäbisch-Hall); J Labenz (Ev Jung-Stilling-Krankenhaus, Siegen); J Kaesberger (Diakonissen-Krankenhaus, Stuttgart); L Leimer (Robert-Bosch-Krankenhaus, Stuttgart); MR Clemens and R Mahlberg (Klinikum Mutterhaus der Borromäerinnen, Trier); R Schwerdtfeger (Deutsche Klinik für Diagnostik, Wiesbaden); R Engberding and R Winter (Stadtkrankenhaus, Wolfsburg); M Sandmann (Klinikum St Antonius, Wuppertal); H Einsele, F Weissinger and H Rueckle-Lanz (Universitätsklinikum, Würzburg).

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Stölzel, F., Pfirrmann, M., Aulitzky, W. et al. Risk stratification using a new prognostic score for patients with secondary acute myeloid leukemia: results of the prospective AML96 trial. Leukemia 25, 420–428 (2011). https://doi.org/10.1038/leu.2010.279

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