1999/10/01 by Keith Wheatley, Alan K. Burnett, Anthony H. Goldstone +6 · 1 citation
Biochemistry, Genetics and Molecular Biology · Medicine · #Acute Myeloid Leukemia Research #Adverse effect #Biology #Clinical trial #Cytogenetics #Disease #Internal medicine #Medicine #Multiple Myeloma Research and Treatments #Myeloid #Myeloid leukaemia #Myeloid leukemia #Oncology #Retinoids in leukemia and cellular processes #Surgery
paper · doi:10.1046/j.1365-2141.1999.01684.x
openalex publication_date 1999/10/01 · openalex created_date 2016/06/24 · openalex updated_date 2026/08/01
Data on 1711 patients, aged up to 55 years, in the MRC AML 10 trial were used to create a prognostic index for use in risk-directed therapy decision making for younger patients with acute myeloid leukaemia (AML). Two parameters, response after course 1 and cytogenetics, were strongly predictive of outcome. For patients with complete remission, partial remission and resistant disease, 5-year survival from the start of course 2 was 53%, 44% and 22% and relapse rates were 46%, 48% and 69% respectively, and for patients with favourable, intermediate and adverse karyotypic abnormalities, survival was 72%, 43% and 17% and relapse rates were 34%, 51% and 75% respectively (all P < 0.0001). Patients with FAB type M3 but no cytogenetic t(15;17) also had a low relapse rate (29%). These three factors were combined to give three risk groups: good (favourable karyotype or M3, irrespective of response status or presence of additional abnormalities), standard (neither good nor poor), poor (adverse karyotype or resistant disease, and no good-risk features). Survival for these three groups was 70%, 48% and 15% respectively and relapse rates were 33%. 50% and 78% (both P < 0.0001). The index is simple (based on just three parameters), robust (derived from 1711 patients), highly discriminatory (55% survival difference between good and poor risk) and validated, so can be applied in the clinical setting to assist with therapeutic decisions as in the current AML 12 trial.