Prognostic value of European LeukemiaNet classification in acute myeloid leukemia

Genetic group	Subsets	CR (%)	DFS (%)	OS (%)
Favorable	t(8;21)(q22;q22); RUNX1-RUNX1T1	Younger adults: 96 Older adults: 83	Younger adults: 55 Older adults: 24	Younger adults: 66 Older adults: 33
	inv(16)(p13.1q22) or t(16;16)(p13.1;q22); CBFB-MYH11
	Mutated NPM1 without FLT3-ITD (normal karyotype)
	Mutated CEBPA (normal karyotype)
Intermediate-I*	Mutated NPM1 and FLT3-ITD (normal karyotype)	Younger adults: 76 Older adults: 61	Younger adults: 23 Older adults: 10	Younger adults: 28 Older adults: 11
	Wild-type NPM1 and FLT3-ITD (normal karyotype)
	Wild-type NPM1 without FLT3-ITD (normal karyotype)
Intermediate-II	t(9;11)(p22;q23); MLLT3-MLL	Younger adults: 79 Older adults: 63	Younger adults: 34 Older adults: 11	Younger adults: 45 Older adults: 16
	Cytogenetic abnormalities not classified as favorable or adverse^¶
Adverse	inv(3)(q21q26.2) or t(3;3)(q21;q26.2); RPN1-EVI1	Younger adults: 50 Older adults: 39	Younger adults: 10 Older adults: 6	Younger adults: 12 Older adults: 3
	t(6;9)(p23;q34); DEK-NUP214
	t(v;11)(v;q23); MLL rearranged
	–5 or del(5q); –7; abnl(17p); complex karyotype^Δ

The European LeukemiaNet classification in AML uses cytogenetic and molecular data to identify four prognostic groups. When applied to 818 younger adults (<60 years) and 732 older adults with primary AML treated within cooperative group trials, the prognostic groups had significantly different rates of CR, DFS, and OS at three years.

AML: acute myeloid leukemia; WHO: World Health Organization; CR: complete remission; DFS: disease-free survival; OS: overall survival.
* Includes all AMLs with normal karyotype except for those included in the favorable subgroup.
¶ For most abnormalities, adequate numbers have not been studied to draw firm conclusions regarding their prognostic significance.
Δ Three or more chromosome abnormalities in the absence of one of the WHO designated recurring translocations or inversions, that is, t(15;17), t(8;21), inv(16) or t(16;16), t(9;11), t(v;11)(v;q23), t(6;9), inv(3) or t(3;3).

Additional data from:

Mrózek K, Marcucci G, Nicolet DJ, et al. Prognostic significance of the European LeukemiaNet standardized system for reporting cytogenetic and molecular alterations in adults with acute myeloid leukemia. J Clin Oncol 2012; 30:4515.

This research was originally published in Blood. Döhner H, Estey EH, Amadori S, et al. Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood 2010; 115:453. Copyright © 2010 American Society of Hematology.

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Prognostic value of European LeukemiaNet classification in acute myeloid leukemia