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Specific scoring systems to predict survival of patients with high-risk myelodysplastic syndrome (MDS) and de novo acute myeloid leukemia (AML) after intensive antileukemic treatment based on results of the EORTC-GIMEMA AML-10 and intergroup CRIANT studies

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Abstract

High-risk myelodysplastic syndrome (MDS) patients have usually a less favorable outcome after intensive treatment compared with de novo acute myeloid leukemia (AML) patients. This may reflect different disease-related and patient-related factors. The purpose of this analysis is to identify disease-specific prognostic factors and to develop prognostic scores for both patient groups. A total of 692 patients in the EORTC/GIMEMA AML-10 study and 289 patients in the CRIANT study received identical remission-induction and consolidation treatment. Estimated 5-year survival rate was 34 % in the AML-10 versus 27 % in the CRIANT study, and estimated disease-free survival was 40 % versus 28 %, respectively. In multivariate analysis, cytogenetic characteristics, white blood count, and age appeared prognostic for survival in both studies. French-American-British (FAB) subtype and performance status were prognostic in the AML-10 study only, whereas number of cytopenias and duration of antecedent hematologic disorder >6 months were prognostic in the CRIANT study only. The prognostic scores distinguish three groups with a 5-year survival rate of 54, 38, and 19 % in the AML-10 study versus 69, 37, and 5 % in the CRIANT study. The prognostic value of these scores has been validated on two external series. The new scoring systems form a practical tool to predict the outcome of individual MDS and AML patients treated with intensive antileukemic therapy.

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Acknowledgments

This publication was supported by grants from the Kankerbestrijding/Koningin Wilhelmina Fonds, The Netherlands, the Kay Kendall Foundation, the Biomed-2 EU grant PL 95-0357, Fonds Cancer (FOCA) from Belgium, and the US National Cancer Institute (grant numbers 5U10-CA11488-23 through 5U10-CA11488-36). The contents are solely the responsibility of the authors and do not represent the official views of the National Cancer Institute (Bethesda, MD, USA). We acknowledge Saint Jude Children’s Research Hospital for providing of a SAS macro allowing the computation of the cumulative incidences of relapse and death in CR. All patients gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study have been omitted.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical standard

All human studies have been approved by the appropriate ethics committee and have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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Authors and Affiliations

  1. Department of Tumor Immunology, Nijmegen Center of Life Sciences, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, Netherlands

    Margriet Oosterveld, Petra Muus & Theo de Witte

  2. EORTC Data Center, Brussels, Belgium

    Stefan Suciu

  3. University Hospital Gasthuisberg, Leuven, Belgium

    Michel Delforge

  4. Heinrich Heine University, Düsseldorf, Germany

    Ulrich Germing, Carlo Aul & Songuel Cakmak-Wollgast

  5. Hôpital Edouard Herriot, Lyon, France

    Amin Belhabri

  6. St Jan’s Hospital, Brugge, Belgium

    Dominik Selleslag

  7. Cliniques Universitaires St Luc, Brussels, Belgium

    Augustin Ferrant

  8. Hôtel Dieu, Paris, France

    Jean-Pierre Marie

  9. Tor Vergata University Hospital, Roma, Italy

    Sergio Amadori

  10. Klinikum Grosshadern, Ludwig-Maximilian University, Munich, Germany

    Ulrich Jehn

  11. University La Sapienza, Roma, Italy

    Franco Mandelli & Marco Vignetti

  12. Kantonsspital, Sankt Gallen, Switzerland

    Uwe Hess

  13. Karolinska Institut, Heddinge University Hospital, Stockholm, Sweden

    Eva Hellström-Lindberg

  14. Clinical Hospital Rebro, Zagreb, Croatia

    Boris Labar

  15. Leiden University Medical Center, Leiden, Netherlands

    Roel Willemze

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  1. Margriet Oosterveld
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Correspondence to Theo de Witte.

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Oosterveld, M., Suciu, S., Muus, P. et al. Specific scoring systems to predict survival of patients with high-risk myelodysplastic syndrome (MDS) and de novo acute myeloid leukemia (AML) after intensive antileukemic treatment based on results of the EORTC-GIMEMA AML-10 and intergroup CRIANT studies. Ann Hematol 94, 23–34 (2015). https://doi.org/10.1007/s00277-014-2177-y

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  • DOI: https://doi.org/10.1007/s00277-014-2177-y

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