Unified classification and risk-stratification in Acute Myeloid Leukemia Journal Article

   


Authors: Tazi, Y.; Arango-Ossa, J. E.; Zhou, Y.; Bernard, E.; Thomas, I.; Gilkes, A.; Freeman, S.; Pradat, Y.; Johnson, S. J.; Hills, R.; Dillon, R.; Levine, M. F.; Leongamornlert, D.; Butler, A.; Ganser, A.; Bullinger, L.; Döhner, K.; Ottmann, O.; Adams, R.; Döhner, H.; Campbell, P. J.; Burnett, A. K.; Dennis, M.; Russell, N. H.; Devlin, S. M.; Huntly, B. J. P.; Papaemmanuil, E.
Article Title: Unified classification and risk-stratification in Acute Myeloid Leukemia
Abstract: Clinical recommendations for Acute Myeloid Leukemia (AML) classification and risk-stratification remain heavily reliant on cytogenetic findings at diagnosis, which are present in <50% of patients. Using comprehensive molecular profiling data from 3,653 patients we characterize and validate 16 molecular classes describing 100% of AML patients. Each class represents diverse biological AML subgroups, and is associated with distinct clinical presentation, likelihood of response to induction chemotherapy, risk of relapse and death over time. Secondary AML-2, emerges as the second largest class (24%), associates with high-risk disease, poor prognosis irrespective of flow Minimal Residual Disease (MRD) negativity, and derives significant benefit from transplantation. Guided by class membership we derive a 3-tier risk-stratification score that re-stratifies 26% of patients as compared to standard of care. This results in a unified framework for disease classification and risk-stratification in AML that relies on information from cytogenetics and 32 genes. Last, we develop an open-access patient-tailored clinical decision support tool. © 2022, The Author(s).
Keywords: genetics; leukemia, myeloid, acute; flow cytometry; cytogenetics; minimal residual disease; neoplasm, residual; health risk; chromosome analysis; cytogenetic analysis; induction chemotherapy; decision support system; disease; acute myeloid leukemia; procedures; humans; human
Journal Title: Nature Communications
Volume: 13
ISSN: 2041-1723
Publisher: Nature Publishing Group  
Date Published: 2022-08-08
Start Page: 4622
Language: English
DOI: 10.1038/s41467-022-32103-8
PUBMED: 35941135
PROVIDER: scopus
PMCID: PMC9360033
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85135551626&doi=10.1038%2fs41467-022-32103-8&partnerID=40&md5=af0a6ff3d1fbd414dd8f4a8f5e0bbd91
Notes: Article -- Export Date: 1 September 2022 -- Source: Scopus
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MSK Authors
  1. Sean McCarthy Devlin
    601 Devlin
  2. Elli Papaemmanuil
    206 Papaemmanuil
  3. Elsa Bernard
    49 Bernard
  4. Max Levine
    34 Levine
  5. Yangyu Zhou
    14 Zhou
  6. Juan Esteban Arango Ossa
    48 Arango Ossa
  7. Yanis Tazi
    7 Tazi
  8. Yoann Cedric Pradat
    1 Pradat
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