Vol.:(0123456789) 1 3
Medical Oncology (2018) 35:141
https://doi.org/10.1007/s12032-018-1179-3
ORIGINAL PAPER
Overall survival of Brazilian acute myeloid leukemia patients
according to the European LeukemiaNet prognostic scoring system:
a cross-sectional study
Tarcila Santos Datoguia
1
· Elvira Deolinda Rodrigues Pereira Velloso
1
· Ricardo Helman
1
·
Juliane Garcez Musacchio
2
· Marco Aurélio Salvino
3
· Rodolfo Almeida Soares
4
· Marcia Higashi
5
·
Adriana Valente Fadel
6
· Rodrigo Santucci Alves e Silva
1
· Nelson Hamerschlak
1
· Fabio Pires de Souza Santos
1
·
Paulo Vidal Campregher
1,7
Received: 7 June 2018 / Accepted: 19 June 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract
Prognostic stratifcation in acute myeloid leukemia (AML) relies, mostly, on cytogenetics and molecular features of leukemic
blasts. The LeukemiaNet prognostic scoring system has been proposed as a standardized way of evaluating prognosis in
AML. We have analysed outcomes in 65 AML cases (median age of 54 years, range 18–82) treated at fve hematology centers
in Brazil stritifed according to the European Leukemia Net (ELN) recommendations for cytogenetic and molecular analysis.
We classifed patients as favorable (N = 13), intermediate-1 (N = 25), intermediate-2 (N = 15), or adverse risk (N = 9). Bone
marrow transplantation (BMT) was performed in 13 patients (21%). Median follow-up was 12 months. The median overall
survival (OS) for all patients was 12.4 months. Median OS was 19.8, 12.4, 10.1, and 10.4 months (p = 0.24) for patients in
the favorable, intermediate-1, intermediate-2, and adverse groups, respectively. Among patients receiving BMT, median OS
was 26.8 months. The ELN is a valuable tool for prognostic stratifcation of AML patients treated in Brazil. Nevertheless,
its usefulness is limited when compared to data from developed countries.
Keywords Acute myeloid leukemia · Risk stratifcation · Stem cell transplantation · Survival
Introduction
Acute myeloid leukemia (AML) is a malignant myeloid neo-
plasm associated with high morbidity and mortality. In Bra-
zil, there are around 8000–9000 new cases per year accord-
ing to the National Cancer Institute (INCA) [1]. Therapy
relies on chemotherapy, hypomethylating agents, targeted
agents, and bone marrow transplantation (BMT), depend-
ing on risk stratifcation and patient performance status [2].
Age, cytogenetic, and molecular alterations at diagnosis
are the most important independent factors used to stratify
patients with AML into prognostic categories. In 2010, the
European Leukemia Net (ELN) proposed a revised prognos-
tic classifcation of AML based on the presence or absence
of specifc cytogenetic and/or molecular aberrations. In
this system, patients are classifed into four subgroups with
markedly distinct outcomes [3]. This system has proven use-
ful when evaluated in retrospective studies [4]. Nevertheless,
few studies have evaluated the ELN scoring system prospec-
tively in a “real-life” scenario, outside clinical trials.
* Paulo Vidal Campregher
paulo.campregher@einstein.brm
1
Centro de Pesquisa Clínica, Instituto Israelita de Ensino e
Pesquisa Albert Einstein, São Paulo, Brazil
2
Centro de Oncologia Integrado, Hospital Quinta D’Or,
Rio de Janeiro, Brazil
3
Complexo Hospitalar Universitário Professor Edgard Santos
(HUPES), Universidade Federal da Bahia (UFBA), Salvador,
Brazil
4
Universidade Federal do Rio Grande do Norte (UFRN),
Natal, Brazil
5
Hospital Amaral Carvalho, Jaú, Brazil
6
Hospital das Clínicas da Faculdade de Medicina de Botucatu,
Botucatu, Brazil
7
Centro de Pesquisa Clínica, Instituto Israelita de Ensino
e Pesquisa Albert Einstein, Av. Albert Einstein, 627/520,
São Paulo CEP 05256-900, Brazil