12th Congress of the European Hematology ... - Haematologica

Acute myeloid leukemia - Clinical I
0046
PROGNOSIS OF ACUTE MYELOID LEUKEMIA IN FIRST RELAPSE:
IMPORTANCE OF THE HOVON/SAKK INDEX
F. Costa, A. Botelho de Sousa
Hospital dos Capuchos, LISBON, Portugal
Background. The outcome of adults with acute myeloid leukemia
(AML) in first relapse is highly unsatisfactory, as very few patients
achieve durable second complete remissions (CR) with intensive reinduction
chemotherapy (CT). Breems et al recently proposed a Prognostic
Index (PI) to be applied to patients ≤ 60 years in first relapse, which may
prove to be a major tool in therapeutic decisions. Aim. To evaluate the
reproducibility of this PI in a cohort of uniformely treated patients at a
single center. Methods. Of 151 consecutive new patients (age 17-60
years) with de novo or secondary AML (excluding promyelocytic
leukemia) treated from May 98 to April 06, 107 achieved CR1, among
whom 55 had relapsed as of June 06. The 50 patients who received intensive
reinduction CT are the object of this analysis. Patients were stratified
into the 3 risk groups of the PI according to the following parameters:
length of CR1, cytogenetics at diagnosis, age at relapse, and whether
previous stem cell transplantation had been performed. Overall survival
(OS) from relapse was compared between the 3 groups. Results. Forty
two percent of the patients achieved CR2. The median OS was 5
months; the overall 1-year survival rate was 25%. The PI defined 3
groups with significantly different 1-year OS: 100% for the favorable
group (comprising 8% of the patients) 40% for the intermediate-risk
group (42% of the patients) and 4% for the poor-risk group (50% of the
patients) [p