Prognostic analysis according to eln 2017 risk stratification, integrated with patient- and treatment- factors, in a cohort of 608 aml patients : a single center «real life» experience

Abstract

Introduction : few studies so far have attempted to validate the ELN risk stratification in a «real life» setting. Moreover the prognostic role of NPM1 mutation in several subsets of patients is still controversial. Although post-induction MRD has a well defined prognostic role, there are few to no data about its relationships with ELN risk stratification. Material and methods :Our retrospective study included a total of 608 AML patients treated at our institute between 1997 and 2019. Mutation testing was performed in all patient with suitable bone marrow or peripheral blood specimen. All the patients were assigned to ELN 2017 risk class according their genetics. Results : ELN 2017 classification effectively stratified AML patients treated with intensive chemotherapy (p65 years old (p=0.25). Within the class of ELN 2017 favorable genetic risk, NPM+ AML had a significantly worse outcome, in terms of OS and EFS, compared to CBF AML (p<0.01). Post-induction MRD had a significant prognostic impact only regarding intermediate (p=0.04) and high (p=0.04) ELN risk class, while its effects was neglegible (p=0.56) regarding favorable ELN risk class. Conclusions : although ELN2017 risk stratification offers a validated prognostic significance in AML patients treated with intensive chemotherapy, it could be amendable with patient- and treatment- factors.