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Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Overview for Acute Myeloid Leukemia (AML)


Risk classification systems under clinical evaluation

Risk classification for treatment assignment on the COG-AAML1031 study is based on cytogenetics, molecular markers, and MRD postinduction I, with patients being divided into a low-risk or high-risk group as follows:

The low-risk group represents about 73% of patients, has a predicted OS of approximately 75%, and is defined by the following:

  • Inv(16), t(8;21), nucleophosmin (NPM) mutations, or CEBPA mutations with any MRD status.
  • Standard-risk cytogenetics with negative MRD at end of Induction I.

The high-risk group represents the remaining 27% of patients, has a predicted OS less than 35%, and is defined by the following:

  • High allelic ratio FLT3/ITD+ with any MRD status.
  • Monosomy 7 with any MRD status.
  • del(5q) with any MRD status.
  • Standard-risk cytogenetics with positive MRD at end of Induction I.

The high-risk group of patients will be offered transplantation in first remission with the most appropriate available donor. Patients in the low-risk group will only be offered transplantation in second complete remission.[52,53]


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This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

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Last Updated: September 04, 2014
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