The findings of a study led by researchers at the OSUCCC – James could refine an important set of diagnostic and treatment recommendations for middle-aged patients with acute myeloid leukemia (AML).
The retrospective study evaluated the molecular characteristics and outcomes of 863 AML patients under age 60 who were treated according to 2017 European LeukemiaNet (ELN) recommendations. The ELN is a European Union-funded organization of physicians, scientists and patients who focus on leukemia. The Ohio State University joined LeukemiaNet in 2014.
ELN recommendations are internationally used for diagnosing and managing people with AML and other leukemias. AML is a blood cancer that affects 19,900 Americans and kills nearly 11,200 of them yearly, according to the American Cancer Society. The OSUCCC – James researchers note that only 35-40% of AML patients under age 60 achieve long-term survival.
This study, published in the journal Leukemia, found that 9% of favorable-risk and 53% of intermediate-risk patients should be reclassified as adverse risk, and that 4% of favorable-risk and 9% of adverse-risk patients should be reclassified as intermediate risk.
"If verified, our findings may refine the ELN risk stratification of younger AML patients, which could improve their treatment choices and outcomes,"says corresponding author Ann-Kathrin Eisfeld, MD, an investigator in the OSUCCC – James Leukemia Research Program.
During this study, Eisfeld and her colleagues detected 2,354 mutations, an average of three per patient (median age 45 years). They also determined the frequency of current ELN risk-group-defining mutations, additional mutations that differed among the risk groups, and mutations in three “functional group” categories: RAS-pathway mutations, kinase and methylation-related mutations, and mutations in genes encoding for spliceosomes, transcription factors and tumor suppressors.
The researchers compared the frequencies of the mutations within each ELN risk group—favorable, intermediate and high—to learn which were associated with better or worse outcomes and might therefore help refine the 2017 ELN classification.
The research paper stemming from this study is dedicated to the memory of its senior author, Clara D. Bloomfield, MD, who died in March 2020 during completion of the manuscript. Bloomfield, a Distinguished University Professor at Ohio State who also served as cancer scholar and senior adviser to the OSUCCC – James, was instrumental in developing the 2017 ELN recommendations, which replaced those that were issued by the ELN in 2010 that were also co-authored by Bloomfield.