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难治性/复发性成人急性髓样白血病患者的一种新型白血病预后评分系统:GOELAMS 研究
A new Leukemia Prognostic Scoring System for refractory/relapsed adult acute myelogeneous leukaemia patients: a GOELAMS study

来自:Leukemia(2011-06-15) 409次阅读 分享

返回本期列表 作者: P Chevallier, M Labopin, P Turlure, T Prebet, A Pigneux, M Hunault, K Filanovsky, P Cornillet-Lefebvre, I Luquet, L Lode, S Richebourg, O Blanchet, N Gachard, N Vey, N Ifrah, N Milpied, J-L Harousseau, M-C Bene, M Mohty, J Delaunay
PMID: 21331073

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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