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ELN-refined 2024 Beat-AML risk stratification for older patients with newly diagnosed AML
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Prognostic impact of the 2022 ELN risk classification and development of a refined BEAT-AML 2024 risk stratification for older patients (aged ≥60 years) with ND AML receiving LIT were published by Hoff et al.1 in Blood Advances. A total of 595 patients with ND AML from the Beat AML trial (NCT03013998) were included; the median age was 73 years, and 42% were female. |
| Key learnings |
| According to the 2022 ELN risk stratification, 78% of patients were classified as adverse risk, 11% as favorable risk, and 11% as intermediate risk. Among 579 patients with OS data, ELN criteria did not distinguish between favorable- and intermediate-risk groups (p = 0.71) but predicted poor OS in those with adverse risk (p < 0.001; C-index: 0.55), with 2-year OS of 47% vs 50% vs 23%, respectively. |
| Multivariable analysis of the training set (n = 316) identified IDH2 mutation as an independent favorable prognostic factor, while KRAS, MLL2, and TP53 mutations were independent unfavorable (p < 0.05). |
| A refined Beat-AML 2024 risk stratification resulted in a “mutation score” that classified patients into two risk groups: −1 to 0 points (Beat-AML intermediate; 41%) vs 1+ points (Beat-AML adverse; 37%). The 2022 ELN favorable- and intermediate-risk patients were reclassified as Beat-AML favorable-risk (22%). |
| The refined risk model showed stronger prognostication for OS, with 2-year OS rates of 48% vs 33% vs 11% in Beat-AML favorable-, intermediate-, and adverse-risk groups, respectively; (p < 0.001; C-index: 0.60). |
| The Beat-AML 2024 model redefines risk for older patients with ND AML undergoing LIT and informs treatment decisions. Further validation of the model is warranted. |
Abbreviations: AML, acute myeloid leukemia; ELN, European LeukemiaNet; LIT, lower-intensity treatment; ND, newly diagnosed; OS, overall survival.
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