Acute Myeloid Leukemia - The Leukemia & Lymphoma Society

Table 2. Some AML Risk FactorsCertain chromosome and gene abnormalities, alone or in combination, mayaffect a patient’s response to treatment. Researchers continue to work ondeveloping better treatments for all patients.Risk Group I Chromosomes 1 (Cytogenetic Analysis) I Genes (Molecular Analysis)Most favorable I 8;21 translocation (M2 subtype) I RUNX1-RUNX1T115;17 translocation (M3 subtype, APL) I PML-RARa (APL)Intermediate16;16 translocation or inversion 16 I CBF-ßMYH11(M4 subtype)No chromosome changesI NPM1 or CEBPAmutation, withoutFLT3-ITDI No chromosome changes9;11 translocation I MLLT3-MLLOther nondefined chromosomechanges (fewer than 3 changes)Trisomy 8 2, 3Least favorable I Deletion of all or part ofchromosomes 5 and 7b6;9 translocation I DEK-NUP214Inversion 3 or 3;3 translocation I RPN1-EVI1v;11q23 translocationI MLL-rearrangedMonosomy 5, del(5q), monosomy 7 3 or more chromosome changes withoutone of the recurring translocations or inversionsNo chromosome changesI FLT3-ITD with or withoutNPM1 mutation ERG andBAALC overexpression1Cytogenetic changes are sometimes abbreviated. For example: A translocation may be written as t(8;21) An inversion may be written as inv(16) A deletion may be written as del(7) or -7 The letter “v” is an abbreviation used to indicate a variable chromosome. For example, an 11q23 translocationsometimes involves genes other than MLL.See pages 33 to 50 for definitions of terms.2Gene association not defined.3 Trisomy 8 is equally distributed among risk subgroups and does not affect risk in the absence of genetic changes.Impact of other genes such as IDH1, IDH2 and WT1 is under continued study.Acute Myeloid Leukemia I page 13