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Prognostic impact of the European LeukemiaNet standardized reporting system in older AML patients receiving stem cell transplantation after non-myeloablative conditioning

Bone Marrow Transplantation volume 52, pages 932–935 (2017)Cite this article

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AML is a biologically heterogeneous disease with highly diverse patient outcomes. A reporting system has been developed by the European LeukemiaNet (ELN) to standardize AML classification.1 The prognostic impact of the four ELN genetic groups (favorable, intermediate-I, intermediate-II and adverse) has mainly been shown in two studies.2, 3 While patients within the favorable genetic group had the best outcome and patients within the adverse genetic group had the worst outcome, the prognosis for younger patients (<60 years) within the intermediate-II genetic group was superior compared to the intermediate-I genetic group. In older patients (⩾60 years), the outcome was comparable between the two intermediate genetic groups.2, 3, 4 These studies focused predominantly on patients who did not receive a hematopoietic stem cell transplantation (HCT) in first CR.1, 2, 3

HCT is an important treatment option for AML patients for whom a suitable donor is available.5, 6 To date, only the study by Röllig et al.2 has analyzed the prognostic impact of the ELN genetic groups in a subgroup of 165 patients under 56 years receiving myeloablative conditioning (12 Gy TBI or busulfan (16 mg/kg) followed by cyclophosphamide (120 mg/kg)) HCT. For these patients, the authors observed no significant outcome differences between the favorable, intermediate-I and intermediate-II genetic groups, but a worse prognosis of the adverse genetic group. Another study by Oran et al.7 analyzed the prognostic impact of a modified ELN classification system—lacking information on NPM1 or CEBPA gene mutation status—in 423 AML patients (including 101 patients ⩾60 years) who underwent HCT in first CR after various conditioning regimens. Here, the modified favorable risk and modified intermediate-II risk genetic groups had the best outcomes for both younger and older patients.

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Acknowledgements

MB was supported by an intramural scholarship of the medical faculty of the University of Leipzig (#990101-089). We thank Janet Bogardt, Annette Jilo and Dagmar Cron for assistance with collecting the AML patient samples. We thank Sabine Leiblein, Christel Müller, Evelin Hennig, Daniela Bretschneider, Christine Günther, Martina Pleß, Ulrike Bergmann and Rainer Krahl who helped to determine the cytogenetics and immunological analysis. Ines Kovacs, Scarlett Schwabe and Christine Günther assisted with material processing. Presented partly in abstract form at the 41st annual meeting of the European Society for Blood and Marrow Transplantation, Istanbul, Turkey, 24 March 2015; and at the ESH-EBMT Training Course on Hematopoietic Stem Cell Transplantation, Budapest, Hungary, 11–14 May 2016.

Author contributions

MB and SS designed and performed the experiments. KS performed the experiments. MB, MJ and SS analyzed and interpreted the data. TL, MC, GB, VV, WP and G-NF provided administrative and technical support. MB and SS wrote, and all authors reviewed and approved the manuscript. DN and SS supervised the study.

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  1. Department of Hematology and Oncology, University of Leipzig, Leipzig, Germany

    M Bill, M Jentzsch, J Grimm, K Schubert, T Lange, M Cross, G Behre, V Vucinic, W Pönisch, G-N Franke, D Niederwieser & S Schwind

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Correspondence to S Schwind.

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Bill, M., Jentzsch, M., Grimm, J. et al. Prognostic impact of the European LeukemiaNet standardized reporting system in older AML patients receiving stem cell transplantation after non-myeloablative conditioning. Bone Marrow Transplant 52, 932–935 (2017). https://doi.org/10.1038/bmt.2017.42

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