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Acute Leukemias

A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

Leukemia volume 25, pages 939–944 (2011)Cite this article

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Abstract

A simplified prognostic score is presented based on the multivariate analysis of 138 refractory/relapsed acute myeloid leukaemia (AML) patients (median age 55 years, range: 19–70) receiving a combination of intensive chemotherapy+Gemtuzumab as salvage regimen. Overall, 2-year event-free survival (EFS) and overall survival (OS) were 29±4% and 36±4%, respectively. Disease status (relapse <12 months, including refractory patients), FLT3-ITD-positive status and high-risk cytogenetics were the three strongest independent adverse prognostic factors for OS and EFS in this series. We then defined three subgroups with striking different outcomes at 2 years: no adverse factor (favourable, N=36): OS 58%, EFS 45%; one adverse factor (intermediate, N=54): OS 37%, EFS 31%; two or three adverse factors (poor, N=43): OS 12%, EFS 12% (P<10−4, P=0.001). This new simplified Leukemia Prognostic Scoring System was then validated on an independent cohort of 111 refractory/relapsed AML patients. This new simplified prognostic score, using three clinical and biological parameters routinely applied, allow to discriminate around two third of the patients who should benefit from a salvage intensive regimen in the setting of refractory/relapsed AML patients. The other one third of the patients should receive investigational therapy.

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Acknowledgements

We would like to acknowledge the continuous support of the cell banking facility (‘tumurotheque’) of the CHU de Nantes, Angers, Limoges, Bordeaux, Marseille, Reims to their ongoing basic and clinical research work. We also thank all the data managers of the CHU de Nantes, Angers, Limoges, Bordeaux, Marseille, Reims, Rehovot and of the GOELAMS.

Author contributions

PC conceived and designed the study, analysed data, recruited patients, provided clinical care, performed bibliographic search and wrote the manuscript. JD recruited patients, provided clinical care, analysed data, performed the statistical analyses and helped in writing the manuscript. ML performed the statistical analyses. MM recruited patients, provided clinical care and helped in writing the manuscript. PT, TP, AP, MH, KF, IL, PCL, LL, SR, OB, NG, NV, NI, NM, JLH and MCB recruited patients, provided clinical care or performed biological analyses and commented on the manuscript. All the above authors approved the manuscript for publication purposes.

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Authors and Affiliations

  1. Service d’Hématologie Clinique, CHU and Université de Nantes, INSERM U892, Nantes, France

    P Chevallier, J-L Harousseau, M Mohty & J Delaunay

  2. ALWP, EBMT-Paris Office, Hôpital Saint Antoine AP-HP, Université Pierre et Marie Curie Paris 6, Paris, France

    M Labopin

  3. Service d’Hématologie Clinique, CHU, Limoges, France

    P Turlure

  4. Département d’Hématologie, Institut Paoli-Calmettes, Marseille, France

    T Prebet & N Vey

  5. Service d’Hématologie Clinique, CHU, Bordeaux, France

    A Pigneux & N Milpied

  6. Service d’Hématologie Clinique, CHU, Angers, France

    M Hunault & N Ifrah

  7. Department of Hematology, Kaplan Medical Center, Rehovot, Israel

    K Filanovsky

  8. Service de Biologie/Hématologie, CHU, Reims, France

    P Cornillet-Lefebvre & I Luquet

  9. Service de Biologie/Hématologie, CHU, Nantes, France

    L Lode & S Richebourg

  10. Servive de Biologie/Hématologie, CHU, Angers, France

    O Blanchet

  11. Service de Biologie/Hématologie, CHU, Limoges, France

    N Gachard

  12. Service de Biologie/Hématologie, CHU, Nancy, France

    M-C Bene

Authors
  1. P Chevallier
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  2. M Labopin
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  3. P Turlure
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  4. T Prebet
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  5. A Pigneux
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  6. M Hunault
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  7. K Filanovsky
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  8. P Cornillet-Lefebvre
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  9. I Luquet
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  10. L Lode
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  11. S Richebourg
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  12. O Blanchet
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  13. N Gachard
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  14. N Vey
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  15. N Ifrah
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  16. N Milpied
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  17. J-L Harousseau
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  18. M-C Bene
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  19. M Mohty
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  20. J Delaunay
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Corresponding author

Correspondence to P Chevallier.

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The authors declare no conflict of interest.

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Chevallier, P., Labopin, M., Turlure, P. et al. A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study. Leukemia 25, 939–944 (2011). https://doi.org/10.1038/leu.2011.25

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