文章：

基于真实世界队列对2022年欧洲白血病网急性髓系白血病患者不良风险分组的优化建议

Proposed Refinement of 2022 European LeukemiaNet Adverse-Risk Group of AML Patients Using a Real-World Cohort

原文发布日期：23 April 2025

DOI: 10.3390/cancers17091405

类型: Article

开放获取: 是

英文摘要：

Background/Objectives:The 2022 European LeukemiaNet (ELN 2022) is a widely used genotypic risk classification tool for the treatment and prognostication of acute myeloid leukemia (AML) patients. Our study evaluates its effectiveness in categorizing adverse-risk AML patients on standard therapy based on their overall survival (OS).Methods: We conducted a retrospective study involving 256 AML patients.Results: Those in the ELN 2022 adverse-risk group had the shortest OS (p< 0.0001) and were predominantly characterized by myelodysplasia-related (MR) mutations, complex karyotype (CK), monosomal karyotype (MK), andTP53mutation (TP53 Mut). Subclassification and analysis of this adverse-risk group based on theTP53 Mutstatus revealed a significantly shorter OS compared to the adverseTP53wild-type (TP53 WT) counterparts (p= 0.0036). We propose refining the ELN 2022 adverse-risk group into two categories, adverseTP53 Mutand adverseTP53 WTgroups, to represent adverse- and ultra-adverse-risk groups, respectively. We used an external validation dataset to confirm our findings.Conclusions: This refinement allows for a more accurate classification of these adverse-risk patients based on their clinical outcomes.

摘要翻译： 

背景/目的：2022年欧洲白血病网（ELN 2022）是目前广泛应用于急性髓系白血病（AML）患者治疗及预后评估的基因型风险分层工具。本研究旨在评估该工具对接受标准治疗的AML不良预后风险患者进行总生存期（OS）分层的有效性。方法：我们开展了一项回顾性研究，纳入256例AML患者。结果：ELN 2022标准界定的不良预后风险组患者OS最短（p<0.0001），其主要特征表现为骨髓增生异常相关（MR）基因突变、复杂核型（CK）、单体核型（MK）及TP53基因突变（TP53 Mut）。根据TP53突变状态对该不良预后风险组进行亚组分析发现，TP53突变亚组患者OS显著短于TP53野生型（TP53 WT）亚组（p=0.0036）。我们建议将ELN 2022不良预后风险组细分为TP53突变型不良预后组与TP53野生型不良预后组，分别代表不良预后风险组与超不良预后风险组，并采用外部验证数据集证实了这一发现。结论：该细化方案能依据临床结局更精准地对不良预后风险患者进行分层。

原文链接：

Proposed Refinement of 2022 European LeukemiaNet Adverse-Risk Group of AML Patients Using a Real-World Cohort