A new prognostic model incorporating molecular data and minimal residual disease (MRD) status allows better stratification and improved pre-transplant survival estimates for adults with AML undergoing allogeneic HCT.
To develop the new model, the AML-specific Disease Risk Group (AML-DRG), researchers at the University of Texas MD Anderson Cancer Center analyzed 1414 consecutively treated adults with AML, randomly assigned into a training (n=944) and validation set (n=470).
The researchers calculated an AML-DRG score using the sum of numbers assigned to AML-related variables: 1 point to secondary AML; 1 point to the 2017 European LeukemiaNet (ELN) adverse risk; 2 points to a Composite Risk score with MRD positive/unknown; and 4 points to active disease at transplant.
The scores were used to create the following AML-DRG categories: low-risk score 0-2; intermediate-risk score 3-4; and high-risk score >4. The scores predicted overall survival in transplanted patients with a Hazard Ratio (HR) of 2.02 (p<0.001) and HR of 3.85 (p<0.001), respectively, for intermediate- and high-risk groups compared with the low-risk group.
The researchers noted that their novel AML-DRG model had a C-index of 0.672, which is better than existing risk-stratification models such as DRI, ELN2017, and standard cytogenetic risk models.
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