% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Ruhnke:300197,
author = {L. Ruhnke and M. Bill$^*$ and S. Zukunft and J.-N. Eckardt
and S. Schäfer and S. Stasik and M. Hanoun and T. Schroeder
and L. Fransecky and B. Steffen and S. W. Krause and S.
Scholl and A. Hochhaus and T. Sauer and S. Kraus and K.
Schäfer-Eckart and M. Kaufmann and E. Jost and T.
Brümmendorf and C. Schliemann and J.-H. Mikesch and U. Krug
and M. Hänel and A. Morgner and M. Schaich and A. Neubauer
and R. Repp and D. Niemann and R. Seggewiss-Bernhardt and A.
Meinhardt and J. Kullmer and U. Kaiser and W. Blau and A.
Kiani and G. U. Grigoleit and A. Giagounidis and A. A.
Wurm$^*$ and H. Altmann and J. M. Middeke and J. Schetelig
and C. Müller-Tidow$^*$ and F. Stölzel and C. D. Baldus
and U. Platzbecker and H. Serve and M. Bornhäuser$^*$ and
C. Thiede and C. Röllig},
title = {{V}alidation of the revised 2022 {E}uropean {L}eukemia{N}et
risk stratification in adult patients with acute myeloid
leukemia.},
journal = {Blood advances},
volume = {9},
number = {6},
issn = {2473-9529},
address = {Washington, DC},
publisher = {American Society of Hematology},
reportid = {DKFZ-2025-00674},
pages = {1392 - 1404},
year = {2025},
abstract = {In 2022, the European LeukemiaNet (ELN) risk stratification
for patients with acute myeloid leukemia (AML) has been
updated. We aimed to validate the prognostic value of the
2022 ELN classification (ELN22) by evaluating 1570 patients
with newly diagnosed AML (median age, 56 years) treated with
cytarabine-based intensive chemotherapy regimens. Compared
with 2017 ELN classification (ELN17), which allocated 595
$(38\%),$ 413 $(26\%),$ and 562 patients $(36\%)$ to the
favorable-, intermediate-, and adverse-risk categories,
ELN22 classified 575 $(37\%),$ 410 $(26\%),$ and 585
patients $(37\%)$ as favorable, intermediate, and adverse
risk, respectively. Risk group allocation was revised in 340
patients $(22\%).$ Most patients were reclassified into the
ELN22 intermediate- or ELN22 adverse-risk group. The
allocation of patients according to the ELN22 risk
categories resulted in a significantly distinct event-free
survival (EFS), relapse-free survival, and overall survival
(OS). Compared with ELN17, reallocation according to the
ELN22 recommendations resulted in a significantly improved
prognostic discrimination for OS (3-year area under the
curve, 0.71 vs 0.67). In patients with ELN22 favorable-risk
AML, co-occurring myelodysplasia-related (MR) gene mutations
did not significantly affect outcomes. Within the ELN22
adverse-risk group, we observed marked survival differences
across mutational groups (5-year OS rate of $21\%$ and $3\%$
in patients with MR gene mutations and TP53 mutations,
respectively). In patients harboring MR gene mutations,
EZH2-, STAG2-, and ZRSR2-mutated patients showed an
intermediate-like OS. In patients with secondary AML and
those who underwent allogeneic hematopoietic cell
transplantation, EFS and OS significantly differed between
ELN22 risk groups, whereas the prognostic abilities of ELN17
and ELN22 classifications were similar. In conclusion, ELN22
improves prognostic discrimination in a large cohort of
intensively treated patients with AML. Given the
heterogeneous outcome in patients with MR gene alterations,
ranging between those of intermediate and adverse risk
patients, we suggest re-evaluation of risk allocation in
these patients.},
keywords = {Humans / Leukemia, Myeloid, Acute: diagnosis / Leukemia,
Myeloid, Acute: therapy / Leukemia, Myeloid, Acute:
mortality / Middle Aged / Male / Adult / Female / Aged /
Prognosis / Risk Assessment / Young Adult / Europe / Aged,
80 and over / Adolescent / Antineoplastic Combined
Chemotherapy Protocols: therapeutic use},
cin = {DD01},
ddc = {610},
cid = {I:(DE-He78)DD01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39504561},
doi = {10.1182/bloodadvances.2024013304},
url = {https://inrepo02.dkfz.de/record/300197},
}